Related Experiment Video
Updated: May 26, 2026
09:03
The CYP2D6 Animal Model: How to Induce Autoimmune Hepatitis in Mice
Published on: February 3, 2012
Azathioprine induced cholestatic hepatitis
Viju Moses1, Banumathi Ramakrishna, Kurien Thomas
1Department of Medicine, Christian Medical College and Hospital, Vellore- 632 004, India.
Indian Journal of Pharmacology
|December 7, 2011
Summary
Azathioprine can cause cholestatic hepatitis, a rare liver condition. This case study shows a full recovery after a prolonged cholestatic phase, offering insights into management.
Area of Science:
- Hepatology
- Clinical Toxicology
- Immunopharmacology
Background:
- Azathioprine is an immunosuppressive drug.
- Drug-induced liver injury is a known adverse effect.
- Cholestatic hepatitis is a specific pattern of liver inflammation.
Purpose of the Study:
- To report a case of azathioprine-induced cholestatic hepatitis.
- To discuss the pathogenesis, epidemiology, and diagnostic challenges of this rare complication.
- To provide recommendations for monitoring and management.
Main Methods:
- Case report.
- Literature review on azathioprine hepatotoxicity.
- Analysis of clinical presentation, diagnostic findings, and treatment course.
Main Results:
- A patient developed cholestatic hepatitis one week after azathioprine exposure.
- The condition presented with a prolonged cholestatic phase.
- Full clinical remission was achieved after discontinuation of the drug.
Conclusions:
- Azathioprine can precipitate a rare but severe cholestatic hepatitis.
- Early recognition and drug withdrawal are crucial for management.
- Monitoring and prompt intervention can lead to favorable outcomes.
Related Concept Videos
01:20Cholecystitis
Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
01:27Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase
Phase II biotransformation reactions are essential for detoxifying and eliminating xenobiotics, including many pharmaceutical compounds. These reactions typically involve conjugation, the covalent attachment of polar endogenous groups such as glucuronic acid, sulfate, methyl, or acetyl moieties to functional groups introduced during Phase I metabolism. The resulting conjugates are more water-soluble, enabling efficient renal or biliary excretion.The major classes of Phase II enzymes include...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:17Hepatic Drug Excretion: Enterohepatic Cycling
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
01:16Hepatic Drug Excretion: Influencing Factors
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...