Azathioprine-related myelosuppression in a patient homozygous for TPMT☆3A

被引：19

作者：

Budhiraja, Pooja ^{[1
]}

Popovtzer, Mordecai ^{[1
]}

机构：

[1] So Arizona Vet Affairs Hlth Care Syst, Tucson, AZ 85723 USA

来源：

NATURE REVIEWS NEPHROLOGY | 2011年 / 7卷 / 08期

关键词：

INFLAMMATORY-BOWEL-DISEASE; ACUTE LYMPHOBLASTIC-LEUKEMIA; THIOPURINE METHYLTRANSFERASE ACTIVITY; TRANSPLANT RECIPIENTS; TPMT; GENOTYPE; MERCAPTOPURINE; PHENOTYPE; PHARMACOGENETICS; 6-MERCAPTOPURINE;

D O I：

10.1038/nrneph.2011.74

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background. A 50-year-old man who had received a simultaneous pancreas and kidney transplant 9 years earlier developed pancytopenia 3 weeks after starting azathioprine therapy to treat worsening proteinuria suspected to be caused by sirolimus. Investigations. Laboratory tests, including complete blood counts, measurement of serum levels of vitamin B-12 and folate, liver function tests, virological assays, and thiopurine S-methyltransferase (TPMT) genotyping. Diagnosis. Severe myelosuppression as a consequence of azathioprine therapy in a patient homozygous for the TPMT(star)3A allele. Management. Discontinuation of azathioprine, treatment with an erythropoiesis-stimulating agent, red blood cell transfusions, filgrastim (a granulocyte colony-stimulating factor analogue) and folic acid.

引用

页码：478 / 484

页数：7

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