Azathioprine-induced pancytopenia:A case report  

作　　者：Keshav Raj Sigdel Astha Thapa Agnimshwor Dahal Ramchandra Panthi Krishan Adhikari Pradeep Shrestha Mipsang Lama Buddhi Poudyal Buddha Basnyat 

机构地区：[1]Department of Internal Medicine,Rheumatology Unit Lagankhel,Patan Academy of Health Sciences,Lalitpur,Nepal [2]Department of Internal Medicine,Hematology Unit Lagankhel,Patan Academy of Health Sciences,Lalitpur,Nepal [3]Department of Internal Medicine,Oxford Clinical Research Unit(OCRU),Patan Academy of Health Sciences,Lalitpur,Nepal

出　　处：《Rheumatology & Autoimmunity》2022年第3期179-184,共6页风湿病与自身免疫（英文）

摘　　要：Azathioprine(AZA)is commonly used as immunosuppressive therapy for autoimmune diseases,including systemic lupus erythematosus(SLE).Myelosuppression is a common side effect of AZA.Here we report a case of severe myelosuppression following AZA therapy in a 15-year-old girl despite a normal thiopurine methyltransferase(TPMT)level.She had been receiving AZA for SLE and presented with neutropenic fever and pancytopenia.AZA was stopped.After stopping AZA,her blood counts steadily improved.When TPMT genotyping results were normal,AZA was reintroduced.Pancytopenia reappeared after starting AZA,despite normal TPMT genotype.AZA was replaced with mycophenolate mofetil which consequently resulted in improvement of blood counts.It is essential to understand the temporal relationship between AZA use and pancytopenia onset in patients with normal TPMT activity.This case illustrates that regular monitoring of blood cell counts should be routine practice after starting AZA regardless of TPMT activity.

关 键 词：AZATHIOPRINE systemic lupus erythematosus thiopurine methyltransferase 

分 类 号：R96[医药卫生—药理学]