a connection between pathological processes and the pigmentation must be restricted to cases with greater than the normal age-related deposition of ceroid pigment".5 Large amounts of lipofuscin have been demonstrated in the livers of patients following excessive intake of phenacetin"6, but not to date in patients taking either ketoprofen or azathioprine. The histological and electron microscopy findings in the case rule out diffuse disease and, by exclusion, strongly suggest a focal pattern of hepatic necrosis. References 1 Urowitz MB, Gordon DA, Smythe HH. Azathioprine treatment of rheumatoid arthritis: a double blind cross-over study.