Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.

BACKGROUND: Azathioprine is widely used in Crohn's disease. A major drawback is the occurrence of side-effects, especially acute pancreatitis. Acute pancreatitis is rarely seen when azathioprine is used for other diseases than Crohn's disease. AIM: To survey side-effects of azathioprine af...

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Main Authors: Weersma, R, Peters, F, Oostenbrug, L, van den Berg, A, van Haastert, M, Ploeg, R, Posthumus, MD, Homan van der Heide, J, Jansen, P, van Dullemen, H
Format: Journal article
Language:English
Published: 2004
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author Weersma, R
Peters, F
Oostenbrug, L
van den Berg, A
van Haastert, M
Ploeg, R
Posthumus, MD
Homan van der Heide, J
Jansen, P
van Dullemen, H
author_facet Weersma, R
Peters, F
Oostenbrug, L
van den Berg, A
van Haastert, M
Ploeg, R
Posthumus, MD
Homan van der Heide, J
Jansen, P
van Dullemen, H
author_sort Weersma, R
collection OXFORD
description BACKGROUND: Azathioprine is widely used in Crohn's disease. A major drawback is the occurrence of side-effects, especially acute pancreatitis. Acute pancreatitis is rarely seen when azathioprine is used for other diseases than Crohn's disease. AIM: To survey side-effects of azathioprine after liver or renal transplantation, for systemic lupus erythematosis, Wegener's granulomatosis, autoimmune hepatitis, rheumatoid arthritis, ulcerative colitis or Crohn's disease. METHODS: A computerized search using the term 'azathioprine' or 'imuran' was performed on the Hospital Information System of the university hospital Groningen, resulting in 1564 patients matching our criteria. RESULTS: Eleven of 224 patients with Crohn's disease experienced acute pancreatitis (4.9%) compared with two of 129 (1.5%) with autoimmune hepatitis, two of 388 (0.5%) after renal transplantation, one of 254 (0.4%) after liver transplantation. Acute pancreatitis was more prevalent in Crohn's disease compared with any other disease. Azathioprine-toxicity necessitating withdrawal occurred significantly (P < 0,05) more in rheumatoid arthritis (78 of 317), ulcerative colitis (20 of 94) and Crohn's disease (52 of 224) compared with systemic lupus erythematosis (five of 73), Wegener's granulomatosis (six of 85), autoimmune hepatitis (eight of 129), after liver transplantation (17 of 254) and after renal transplantation (22 of 388). CONCLUSIONS: Acute pancreatitis is strongly associated with Crohn's disease and rarely occurs with other underlying conditions. Overall azathioprine-induced toxicity and the necessity of withdrawal is more common in inflammatory bowel disease and rheumatoid arthritis compared with other diseases.
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spelling oxford-uuid:1868c0f9-743f-4c18-968e-64b92a73d54a2022-03-26T10:43:08ZIncreased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1868c0f9-743f-4c18-968e-64b92a73d54aEnglishSymplectic Elements at Oxford2004Weersma, RPeters, FOostenbrug, Lvan den Berg, Avan Haastert, MPloeg, RPosthumus, MDHoman van der Heide, JJansen, Pvan Dullemen, HBACKGROUND: Azathioprine is widely used in Crohn's disease. A major drawback is the occurrence of side-effects, especially acute pancreatitis. Acute pancreatitis is rarely seen when azathioprine is used for other diseases than Crohn's disease. AIM: To survey side-effects of azathioprine after liver or renal transplantation, for systemic lupus erythematosis, Wegener's granulomatosis, autoimmune hepatitis, rheumatoid arthritis, ulcerative colitis or Crohn's disease. METHODS: A computerized search using the term 'azathioprine' or 'imuran' was performed on the Hospital Information System of the university hospital Groningen, resulting in 1564 patients matching our criteria. RESULTS: Eleven of 224 patients with Crohn's disease experienced acute pancreatitis (4.9%) compared with two of 129 (1.5%) with autoimmune hepatitis, two of 388 (0.5%) after renal transplantation, one of 254 (0.4%) after liver transplantation. Acute pancreatitis was more prevalent in Crohn's disease compared with any other disease. Azathioprine-toxicity necessitating withdrawal occurred significantly (P < 0,05) more in rheumatoid arthritis (78 of 317), ulcerative colitis (20 of 94) and Crohn's disease (52 of 224) compared with systemic lupus erythematosis (five of 73), Wegener's granulomatosis (six of 85), autoimmune hepatitis (eight of 129), after liver transplantation (17 of 254) and after renal transplantation (22 of 388). CONCLUSIONS: Acute pancreatitis is strongly associated with Crohn's disease and rarely occurs with other underlying conditions. Overall azathioprine-induced toxicity and the necessity of withdrawal is more common in inflammatory bowel disease and rheumatoid arthritis compared with other diseases.
spellingShingle Weersma, R
Peters, F
Oostenbrug, L
van den Berg, A
van Haastert, M
Ploeg, R
Posthumus, MD
Homan van der Heide, J
Jansen, P
van Dullemen, H
Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title_full Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title_fullStr Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title_full_unstemmed Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title_short Increased incidence of azathioprine-induced pancreatitis in Crohn's disease compared with other diseases.
title_sort increased incidence of azathioprine induced pancreatitis in crohn s disease compared with other diseases
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