A Case of Azathioprine Induced Severe Myelosuppression and Alopecia Totalis in IgA Nephropathy.
10.3339/jkspn.2017.21.1.35
- Author:
Jae Choon KIM
1
;
Ye Kyung KIM
;
Hye Sun HYUN
;
Eu Jin PARK
;
Hee Gyung KANG
;
Il Soo HA
;
Hae Il CHEONG
Author Information
1. Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea. kanghg@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Azathioprine;
IgA nephropathy;
Pancytopenia;
Alopecia
- MeSH:
Alopecia*;
Azathioprine*;
Bone Marrow;
Child;
Glomerulonephritis;
Glomerulonephritis, IGA*;
Granulocyte Colony-Stimulating Factor;
Hair;
Humans;
Immunoglobulin A*;
Male;
Metabolism;
Pancytopenia
- From:Childhood Kidney Diseases
2017;21(1):35-39
- CountryRepublic of Korea
- Language:English
-
Abstract:
Azathioprine is commonly used as immunosuppressive therapy for various inflammatory diseases including chronic glomerulonephritis. Myelosuppression is a common side effect of azathioprine, resulting in the need for dose reduction. However, severe pancytopenia or alopecia is not often encountered. Here, we report a case of severe myelosuppression, and alopecia totalis that occurred after azathioprine treatment in a patient with IgA nephropathy. A 10-year-old boy with IgA nephropathy was treated with oral deflazacort and later with azathioprine. After 4 weeks, the patient complained of hair loss, and despite a dose reduction in azathioprine, he developed bone marrow suppression and alopecia totalis in two weeks. The blood indices and alopecia of the patient had returned to normal after azathioprine withdrawal and 3 consecutive doses of granulocyte colony-stimulating factor. We suggest that physicians remain vigilant to the side effects of azathioprine. Unusual hair loss after azathioprine treatment might suggest a defect in the metabolism of the drug, warranting the discontinuation of azathioprine to prevent more severe side effects.
