Drug Hypersensitivity due to Azathioprine with Elevated Procalcitonin

We present a case of azathioprine hypersensitivity presenting as sepsis with elevated procalcitonin in a 68-year-old man with myasthenia gravis. The patient presented with fever, chills, nausea, vomiting, and headache. He developed numerous 1 cm erythematous papules over his upper torso. Infectious...

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Published inCase reports in dermatological medicine Vol. 2018; no. 2018; pp. 1 - 4
Main Authors Ahuja, Tania, Ruiz-Maya, Tania, Chung, Frank R.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 2018
Hindawi
Hindawi Limited
Wiley
Subjects
Allergies
Allergy
Azathioprine
Blood tests
C-reactive protein
Case Report
Case reports
Dermatology
Diagnostic errors
Drug hypersensitivity
Drug therapy
Family medical history
Fever
Folliculitis
Headache
Health aspects
Immunosuppressive agents
Infection
Infectious diseases
Laboratories
Medical schools
Metabolism
Metabolites
Myasthenia gravis
Patients
Proteins
Rheumatoid arthritis
Sepsis
Side effects
Skin
Skin diseases
Systematic review
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Summary:We present a case of azathioprine hypersensitivity presenting as sepsis with elevated procalcitonin in a 68-year-old man with myasthenia gravis. The patient presented with fever, chills, nausea, vomiting, and headache. He developed numerous 1 cm erythematous papules over his upper torso. Infectious workup including bacteriological tests and microbial cultures was negative and a skin biopsy was performed which revealed suppurative folliculitis with eosinophils, consistent with drug hypersensitivity. Notably, acute phase reactants including C-reactive protein and procalcitonin were elevated upon presentation, likely secondary to drug hypersensitivity.
Bibliography:Academic Editor: Alireza Firooz
ISSN:2090-6463
2090-6471
DOI:10.1155/2018/2648325