Azathioprine-induced myelosuppression in a systemic lupus erythematosus patient: case report
DOI:
https://doi.org/10.60104/revhugv9967Keywords:
Systemic Lupus Erythematosus, toxicity, azathioprine, myelosuppression.Abstract
Azathioprine (AZA) is an immunosuppressive drug widely used in the management of systemic lupus erythematosus (SLE), also is indicated for the treatment of hemolytic anemia, thrombocytopenia, and as maintenance regimen to treat lupus nephritis. However, there are some side effects that may occur with this drug, including bone marrow suppression. Leukopenia is the most common hematologic manifestation, nevertheless there are some cases of bone marrow aplasia described in the literature. We describe a case of a 32-year-old-woman who had been diagnosed with SLE, according to the criteria of the American College of Rheumatology (ACR), who developed fever, hematochezia, diffuse petechiae and pancytopenia. Performed antimicrobial treatment and granulokine, due febrile neutropenia, and optimization of corticosteroid therapy but without satisfactory clinical evolution. Bone marrow biopsy: marked hypoplasia of granulocytic and erythroid series and absence of megakaryocytes series. The patient had satisfactory clinical and laboratory evolution 30 days after suspension of the AZA. The study revealed that the occurrence of bone marrow aplasia secondary to the use of AZA is rare, but the complete suspension of the drug is necessary for full recovery of the white and red blood cell series.
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References
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