Severe myelosuppression following alopecia shortly after the initiation of 6-mercaptopurine in a patient with Crohn's disease.
A 15-year-old, woman, Crohn's disease patient, who carried the TPMT *3C heterozygous mutant, complained of alopecia 3 days after starting 6-mercaptopurine (6-MP) and then developed severe myelosuppression 6 weeks after starting 6-MP. The alopecia involved scalp hair only (body hair preserved) and was dominant in the temporal region. Following these side effects, transient remission of Crohn's disease occurred. Myelosuppression due to 6-MP is a rare but life-threatening side effect that is difficult to predict despite continuous monitoring of complete blood cell counts. In the present case, 6-MP-induced alopecia preceded myelosuppression and progressed rapidly as the myelosuppression worsened.
Jichi Medical University, Saitama Medical Center. ugajin@kurosu-hospital.jp
Takuhiro
T
Ugajin
Hiroyuki
H
Miyatani
Toshio
T
Demitsu
Takaaki
T
Iwaki
Shinya
S
Ushimaru
Yoshiyuki
Y
Nakashima
Yukio
Y
Yoshida
D000293:Adolescent; D000505:Alopecia / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D001853:Bone Marrow / Q000187:drug effects*; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D015122:Mercaptopurine / Q000009:adverse effects* / Q000627:therapeutic use
D015122:Mercaptopurine