Hepatotoxicity due to azathioprine in a patient with nephrotic syndrome

Hepatotoxicity due to azathioprine (AZA) is uncommon, and evidence favoring AZA hepatotoxicity in humans remains controversial, since most cases previ ously described have occurred in patients recuperating from renal transplan tation who had underlying diseases that may affect the liver, or who were t aking other medications with hepatotoxic potential, or in whom complete or incomplete serologic studies to exclude viral hepatitis were absent. We des cribe a young man with nephrotic syndrome due to minimal change disease, in whom biochemical evidence of hepatocellular damage developed 6 weeks after initiation with AZA therapy. The liver damage completely resolved after dr ug withdrawal and recurred 4 days after a second challenge with AZA. The pr esent case provides additional evidence that, in humans, AZA could be hepat otoxic. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.