ACG case reports journal
Cure8 research brief
Why This Matters
Azathioprine can rarely cause serious liver vascular disease (PSVD) leading to portal hypertension and portal vein thrombosis; patients on long-term thiopurines may need monitoring and prompt evaluation for cytopenias or signs of portal hypertension.
Who Should Pay Attention
Adult patients on long-term thiopurines, gastroenterologists, hepatologists, clinicians monitoring blood tests
Study Snapshot
Story typeResearch paper
Evidence typeResearch paper
Source depthJournal abstract
What To Know
A 48-year-old man with ileocolonic Crohn's disease developed persistent leukopenia and thrombocytopenia after about 15 years on azathioprine.
Imaging and endoscopy showed portal hypertension and extensive portal vein thrombosis; liver biopsy demonstrated nodular regenerative hyperplasia and obliterative portal venopathy without cirrhosis, consistent with PSVD.
Azathioprine was stopped and the patient was treated with carvedilol and anticoagulation; after 4 years the portal thrombosis recanalized, portal hypertension stabilized, and Crohn's disease remained in deep remission.
This report highlights the need for long-term monitoring for liver-related complications in patients on thiopurines and consideration of drug discontinuation if PSVD is suspected. It does not provide evidence about incidence, risk factors, or management beyond this single case.
Keep In Mind
This is an abstract of a single case report; it documents one patient's course and management and does not provide population-level risk estimates. The source is ACG Case Reports Journal via PubMed.
Source Details
Review the original publication for the complete reporting, methods, and context.
Research paper
Evidence type derived from source or registry metadata.
PublicationACG case reports journal
AuthorsFoudhil Azizi, Rachid Ouldgougam, Youness Aouameur +4 more
InstitutionDepartment of Hepatology and Internal Medicine, Bologhine Ibn Ziri hospital, Algiers, Algeria.
Study typeCase reports, journal article
Indexed viaPubMed
Source typeResearch paper
PublishedNov 4, 2026, 12:00 AM
Content availableJournal abstract
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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