Azathioprine-induced severe pancytopenia: A serious complication in a patient with normal TPMT activity

Azathioprine is an immunomodulator commonly used in renal transplant recipients and to treat lupus erythematous, inflammatory bowel disease, as second-line therapy cases of rheumatoid arthritis. Here, we present a case non-segmental vitiligo treated with low-dose azathioprine developing life-threatening pancytopenia febrile neutropenia trephine biopsy-proven drug-induced myelosuppression. The patient needed broad-spectrum antibiotics granulocyte colony-stimulating factor (G-CSF) support intermittent transfusion blood products completely recover from It took almost month for the cytotoxicity caused by azathioprine. Interestingly, had normal thiopurine methyl transferase (TPMT) activity wild-type TPMT allele. We tried outline how these types patients can be managed emphasize need continuous monitoring counts receiving prevent cytopenia even