Medullary aplasia due to the use of azathioprine in a patient with autoimmune hepatitis. Case report
DOI:
https://doi.org/10.5281/zenodo.13736220Keywords:
azathioprine, immunosuppressant, medullary aplasia, hepatitis, pancytopeniaAbstract
Azathioprine is an immunosuppressive drug derived from 6-mercaptopurine, used in the treatment of various autoimmune conditions. Its metabolism mainly involves xanthine oxidase and thiopurine methyltransferase (TPMT). Adverse effects of azathioprine include allergic reactions and myelotoxicity, such as leukopenia, thrombocytopenia, and anemia, the incidence of which can be as high as 46% in patients with autoimmune hepatitis. The case presented describes a 68-year-old woman with autoimmune hepatitis initially treated with prednisone and continued with azathioprine. He subsequently developed hair loss, asthenia, and weight loss, along with laboratory-confirmed pancytopenia. After the diagnosis of spinal cord aplasia secondary to azathioprine toxicity, the medication was discontinued and treatment with antibiotics, transfusions and corticosteroids was initiated, achieving complete hematological recovery and favorable evolution.
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