AZATHIOPRINE INDUCED PANCYTOPENIA-A CASE REPORT
Journal Title: International Journal of Pharmacy and Pharmaceutical Sciences - Year 2017, Vol 9, Issue 2
Abstract
Azathioprine (AZA), a prodrug of 6 mercaptopurine, is an immunosuppressant that can be used as adjunctive therapy with corticosteroids in the treatment of arteritic form of ischemic optic neuropathy. Although myelotoxicity is known to occur while using azathioprine, severe pancytopenia is rarely seen. Patients with thiopurine methyltransferase (TPMT) deficiency are at high risk of developing severe myelosuppression. A 63 year* old female with ischemic optic neuropathy was initiated treatment with oral methylprednisone. As two courses of oral steroids showed no significant improvement, oral azathioprine 25 mg twice daily was added and gradually increased to 50 mg twice daily with relief of symptoms. 6 mo later, she was admitted with acute stroke and lab reports showed low levels of total blood counts or pancytopenia. The patient was put on broad spectrum antibiotics; given injection of granulocyte colony stimulating factor 300 mcg subcutaneously and blood transfusion as correction till counts normalised. She improved over 14 d and on next follow-up counts were in normal range. Causality was assessed by Naranjo causality assessment scale and a probable relationship was obtained between azathioprine and pancytopenia with a score of 6. Variations in TPMT activity occurs due to genetic polymorphism. Physicians should be aware of the possibility of myelosuppression while prescribing azathioprine. Frequent blood count monitoring is the most convenient way to avoid this problem where testing for TPMT deficiency is not possible.
Authors and Affiliations
Jeslyn Mary Philip, Parvathypriya C. , Christeena George, Meenu Vijayan
Keywords
Related Articles
- EP ID EP575865
- DOI 10.22159/ijpps.2017v9i2.15801
- Views 62
- Downloads 0
WOUND HEALING POTENTIAL OF YOUNG LEAVES OF TRITICUM AESTIVUM ON ALLOXAN INDUCED DIABETIC RATS
Objective: Wheatgrass is known to have several medicinal properties to treat various disorders. Triticum aestivum Linn. is a traditional medicinal plant apparently used for bowel disorders, skin inflammation, infection,...
THE APPLICATION OF COMMUNICATION TECHNOLOGY IN HOSPITAL AND COMMUNITY PHARMACIES: A BRIEF REVIEW
The use of communication technology has brought positive changes to the healthcare delivery system of today. Both healthcare professionals and patients have found a better option to access relevant health and drug inform...
ASSAY METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS QUANTITATIVE ESTIMATION OF DILOXANIDE FUROATE AND TINIDAZOLE IN TABLETS BY RP-HPLC
Objective: To develop an accurate, precise and linear Reverse Phase High Performance Liquid Chromatographic (RP-HPLC) method for simultaneous quantitative estimation of Diloxanide furoate and Tinidazole in tablets and va...
IN VITRO EQUIVALENCE STUDY OF GENERIC NAPROXEN SODIUM TABLETS USING THE USP PADDLE APPARATUS AND THE FLOW-THROUGH CELL METHOD
Objective: To perform an in vitro equivalence study of naproxen sodium from six immediate release oral dosage forms under the hydrodynamic environments generated by the flow-through cell method and the USP paddle apparat...
ANTIMALARIAL ACTIVITY AND CYTOTOXICITY STUDY OF ETHANOL EXTRACT AND FRACTION FROM ALECTRYON SERRATUS LEAVES
Objective: The resistance of Plasmodium falciparum to standard antimalarial drugs has led the scientist to investigate medicinal plants as new potentials in the treatment or prevention of malaria. Previous study showed t...