title: Three hospital admissions in 9 days to diagnose azathioprine hypersensitivity in a patient with Crohn's disease.
abstract: Azathioprine (AZA) is commonly used as a steroid-sparing immunosuppressive medication for the treatment of immune-mediated disorders including Crohn's disease. There is ample awareness of the more common adverse effects of this drug, including myelosuppression and risk of malignancy. We present a case of a 57-year-old man with fistulizing Crohn's disease who underwent 3 hospital admissions for recurrent fever with an extensive work-up for infection before the diagnosis of AZA hypersensitivity was made. Clinicians should be vigilant for AZA hypersensitivity as a cause of otherwise unexplained fever. Furthermore, in patients with inflammatory bowel disease (IBD), the signs and symptoms of AZA hypersensitivity may overlap with typical findings of inflammatory bowel disease flare.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Somnath
authors.initials: S
authors.lastname: Mookherjee
authors.forename: Maya
authors.initials: M
authors.lastname: Narayanan
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Wentworth
mesh_terms: D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy / Q000503:physiopathology; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine