title: [Azathioprine-induced pancytopenia: case series].
abstract: Azathioprine is an immunosuppressive drug that has shown effectiveness in inflammatory bowel disease treatment. Its metabolite, 6-mercaptopurine, is metabolized through thiopurine methyltransferase. Patients with low enzyme activity may have more frequent and severe side effects. The most common is leukopenia, and rarely pancytopenia. The thiopurine methyltransferase activity monitoring shows an individualized profile of enzymatic activity but it should not replace monitoring by performing serial blood counts. In patients with fever and severe neutropenia, early empirical antibiotic treatment should be initiated to prevent severe and disseminated infection. Two patients with this condition are reported.
authors.affiliation: Servicio de Pediatría, Hospital Infantil Miguel Servet, Zaragoza, España. cmartinezf@salud.aragon.es.
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez Faci
authors.affiliation: Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Infantil Miguel Servet, Zaragoza, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ros Arnal
authors.affiliation: Servicio de Pediatría, Hospital Infantil Miguel Servet, Zaragoza, España.
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez de Zabarte Fernández
authors.affiliation: Servicio de Pediatría, Hospital Infantil Miguel Servet, Zaragoza, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sorribes Estorch
authors.affiliation: Servicio de Pediatría, Hospital Infantil Miguel Servet, Zaragoza, España.
authors.forename: Mónica
authors.initials: M
authors.lastname: López Campos
authors.affiliation: Unidad de Hematología y Oncología Pediátrica, Hospital Infantil Miguel Servet, Zaragoza, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodríguez-Vigil Iturrate
mesh_terms: D000293:Adolescent; D001379:Azathioprine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D010198:Pancytopenia / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Azathioprine; Pancytopenia; Toxicity