Adverse Events Associated with Azathioprine Treatment in Korean Pediatric Inflammatory Bowel Disease Patients
A 9-year-old girl was hospitalized with fever, and numerous erythematous, pustular lesions with tenderness on her face and both arms. Due to her prednisolone-dependent ulcerative colitis, AZA treatment with a dose of 1 mg/kg/day had been initiated 10 days before admission. Laboratory tests showed leukocytosis and markedly raised erythrocyte sedimentation rate and C-reactive protein level on admission. Despite antibiotic treatment after admission, fever continued and skin lesions worsened. Skin biopsy was performed, and pathologic examination revealed massive neutrophilic infiltrates in the entire dermis. Tissue culture results were negative for bacterial and fungal infection. Considering the clinical course, laboratory findings, and histopathologic examinations, Sweet syndrome was suspected. Two days after discontinuing treatment with AZA, the fever subsided and skin lesions showed improvement.