{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:46:15Z","timestamp":1756464375943,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,1,5]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Azathioprine (AZA) is an immunosuppressive drug that is widely used in the treatment of autoimmune diseases. Although AZA is used widely, many studies reported that AZA-related hepatotoxicity is rather rare. We aimed to present a case with severe cholestatic hepatitis due to AZA use for Behcet\u2019s disease. Three weeks after starting AZA for the treatment of uveitis, the patient was admitted to our clinic with cholestasis and constitutional symptoms. In liver biopsy, findings were in accordance with drug reaction, and the AZA treatment was stopped. After 2\u2009months, bilirubin levels and liver tests results became normal. As a result, given that AZA may cause severe cholestasis, the drug should be stopped if idiosyncrasy or hypersensitivity develops. If there is a debate in the diagnosis, histopathological evaluation of the liver would be the major issue because of the correct diagnosis of the drug toxicity and excluding other aetiologies.<\/jats:p>","DOI":"10.1136\/bcr-2018-226340","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T08:05:50Z","timestamp":1554105950000},"page":"e226340","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Severe cholestasis due to azathioprine in Behcet\u2019s disease"],"prefix":"10.1136","volume":"12","author":[{"given":"Kadir","family":"Gisi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Ispiroglu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bulent","family":"Kantarceken","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamide","family":"Sayar","sequence":"additional","affiliation":[{"name":"Department of pathology, Faculty of Medicine, Mersin University, Kahramanmaras, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,31]]},"reference":[{"key":"2025082803062936000_12.3.e226340.1","doi-asserted-by":"crossref","first-page":"733","DOI":"10.4103\/0253-7613.89840","article-title":"Azathioprine induced cholestatic hepatitis","volume":"43","author":"Moses","year":"2011","journal-title":"Indian J Pharmacol"},{"key":"2025082803062936000_12.3.e226340.2","doi-asserted-by":"crossref","first-page":"401","DOI":"10.3349\/ymj.1997.38.6.401","article-title":"Treatment of Beh\u00e7et\u2019s disease","volume":"38","author":"Bang","year":"1997","journal-title":"Yonsei Med J"},{"key":"2025082803062936000_12.3.e226340.3","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1590\/S0004-28032012000200007","article-title":"Toxicity of azathioprine: why and when? 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