Thiopurine Induced Liver Injury comes under the PRED4 umbrella and started in January 2014.
Inclusion Criteria
• History of inflammatory bowel disease
• Normal ALT and bilirubin at baseline
• No history of chronic liver disease
• Elevation of ALT and/or bilirubin to ≥4 times upper limit of normal
• History of thiopurine exposure in the previous 30 days prior to abnormal blood test
• Medical opinion implicating thiopurine in development of hepatotoxicity leads to dose reduction/ drug withdrawal (even temporary)
Codes which we have found helpful to identify patients:
Ask Biochemistry to search for patients who have been referred by the Gastro team with total ALT and/or bilirubin to ≥4 times ULN
Combine for Ulcerative Colitis (K51) + Y40-Y59 (Drugs, medicaments and biological substances causing adverse effects)
Or Combine for Crohn’s Disease (K50) + Y40-Y59 (Drugs, medicaments and biological substances causing adverse effects)
Cross reference Immunosuppressive agents (Y43.4) against Ulcerative Colitis (K51) and Crohn’s Disease (K50)
Combine for Ulcerative Colitis (K51) + (K71) Liver toxicity Or Combine for Crohn’s Disease (K50) + (K71) Liver toxicity
You can also log on to the link www.ibdresearch.net and enter the information here. You will need to request a user name and password from Claire Bewshea email claire.bewshea@nhs.net.