Aplastic anemia secondary to azathioprine in systemic lupus erythematosus: report of a case with normal thiopurine S-methyltransferase enzyme activity and review of the literature

Azathioprine-induced aplastic anemia and fatal myelosuppression is a rare occurrence in patients with systemic lupus erythematosus (SLE). We report a case of a 53-year-old female with a normal thiopurine S-methyltransferase (TPMT) level who developed aplastic anemia within 4 weeks of azathioprine in...

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Bibliographic Details
Published inLupus Vol. 22; no. 14; pp. 1526 - 1528
Main Authors Yeter, KC, Afkhami, M, Brynes, RK, Quismorio, FP
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.12.2013
Sage Publications Ltd
Subjects
Alopecia
Anemia
Anemia, Aplastic - chemically induced
Anemia, Aplastic - physiopathology
Antibiotics
Azathioprine - adverse effects
Azathioprine - therapeutic use
Baldness
Biopsy
Blood
Bone marrow
Bronchoscopy
Case reports
Drug dosages
Enzymes
Fatal Outcome
Female
Fever
Hospitals
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Literature reviews
Lupus
Lupus Erythematosus, Systemic - drug therapy
Medicine
Methyltransferases - metabolism
Middle Aged
Patients
Rheumatology
Steroids
Toxicity
Vitamin deficiency
Los Angeles County California
Los Angeles California
United States > US
hematologic changes
azathioprine
Systemic lupus erythematosus
musculoskeletal
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Summary:Azathioprine-induced aplastic anemia and fatal myelosuppression is a rare occurrence in patients with systemic lupus erythematosus (SLE). We report a case of a 53-year-old female with a normal thiopurine S-methyltransferase (TPMT) level who developed aplastic anemia within 4 weeks of azathioprine initiation, resulting in death. Physicians should be vigilant in monitoring routine blood work when administering azathioprine, a relatively common drug, in patients with SLE.
Bibliography:ObjectType-Case Study-3
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ObjectType-Feature-5
ObjectType-Report-2
ObjectType-Article-4
ObjectType-Article-2
ObjectType-Feature-1
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203313504636