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Sinusoidal dilatation: a rare side effect of azathioprine
  1. A M Jacobi1,
  2. E Feist1,
  3. B Rudolph2,
  4. G R Burmester1
  1. 1Department of Medicine, Rheumatology and Clinical Immunology, University Hospital Charité, Berlin, Germany
  2. 2Department of Pathology, University Hospital Charité, Berlin, Germany
  1. Correspondence to:
    Dr A M Jacobi
    Department of Medicine/Rheumatology and Clinical Immunology, University Hospital Charité, Schumannstr 20/21, 10098 Berlin, Germany; annett.jacobicharite.de

https://doi.org/10.1136/ard.2003.017855

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    Hepatotoxicity is an often reported side effect of azathioprine treatment, which requires monitoring of serum transaminases and γ-glutamyltransferase (γ-GT), especially during the first 6 months of treatment. This case report, however, illustrates that side effects of azathioprine can also occur after a longer period of treatment. We report a case of sinusoidal dilatation as a rare side effect of azathioprine treatment in a patient with systemic sclerosis.

    CASE REPORT

    A 50 year old female patient with systemic sclerosis presented with a rapid increase of body weight (approximately 5 kg within 3 days) and abdominal circumference, diffuse abdominal pain, oedema of the lower extremities, dyspnoea, tachycardia, and low blood pressure (90/60 mm Hg). Because systemic sclerosis with pulmonary involvement had been diagnosed 1½ years previously, the patient received azathioprine (2 mg/kg) and prednisone (5 mg) daily. The patient tested positive …

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