Which antimetabolite is associated with hepatoportal sclerosis and esophageal varices?

Thioguanine is an antimetabolite that has been linked to the development of hepatoportal sclerosis and esophageal varices. This connection arises from the drug's impact on liver metabolism and its potential to cause hepatotoxicity. Hepatoportal sclerosis refers to a type of liver damage that can lead to increased portal vein pressure and subsequently result in esophageal varices, which are dilated veins in the esophagus that can cause significant complications, including bleeding.

When patients are treated with thioguanine, they may experience damage to the liver that can progress to conditions like veno-occlusive disease or portal hypertension. This adverse effect underscores the importance of monitoring liver function in patients receiving thioguanine and being aware of the risks associated with its use.

While other agents listed may have their own side effects and toxicities, they are not specifically associated with the combination of hepatoportal sclerosis and esophageal varices to the same degree as thioguanine. Therefore, understanding the distinct hepatic risks tied to thioguanine is crucial when considering the overall management of patients undergoing chemotherapy with this agent.