title: Hypersensitivity to azathioprine mimicking gastroenteritis. Absence of recurrence with 6-mercaptopurine.
abstract: Hypersensitivity mimicking gastroenteritis is a rare complication of azathioprine therapy for which the mechanism is unknown. We report a case of devastating diarrhoea and vomiting due to azathioprine treatment in which hypersensitivity to the imidazole moiety of azathioprine was demonstrated. This has important therapeutic implications: in this situation, 6-mercaptopurine, which is the portion of azathioprine responsible for the cytotoxic therapeutic effect, can be administered without recurrence of side-effects.
authors.affiliation: Service de Médecine Interne, Hôpital Henri-Mondor, Creteil.
authors.forename: B
authors.initials: B
authors.lastname: Godeau
authors.forename: M
authors.initials: M
authors.lastname: Paul
authors.forename: J E
authors.initials: JE
authors.lastname: Autegarden
authors.forename: F
authors.initials: F
authors.lastname: Leynadier
authors.forename: A
authors.initials: A
authors.lastname: Astier
authors.forename: A
authors.initials: A
authors.lastname: Schaeffer
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000139:chemically induced*; D004427:Ear Diseases / Q000188:drug therapy*; D005759:Gastroenteritis / Q000175:diagnosis; D006801:Humans; D007634:Keratitis / Q000188:drug therapy*; D008297:Male; D015122:Mercaptopurine / Q000627:therapeutic use*; D013577:Syndrome; D015837:Vestibular Diseases / Q000188:drug therapy
chemical_list: D015122:Mercaptopurine; D001379:Azathioprine