Adverse Events Associated with Azathioprine Treatment in Korean Pediatric Inflammatory Bowel Disease Patients
A 15-year-old boy who had been diagnosed with CD was admitted with complaints of high fever and oral lesions for 2 days. Treatment with AZA had been initiated 1 month before with a dose of 2.5 mg/kg/day, which had been prescribed at an other hospital. Neutropenia occurred 7 days after treatment with AZA and drug doses were reduced to 1 mg/kg/day. The initial laboratory test at admission showed pancytopenia, with a white blood cell count of 1,700/mm3, an absolute neutrophil count of 70/mm3, hemoglobin of 11.7 g/dL, and a platelet count of 45,000/mm3. Despite discontinuation of treatment with AZA, pancytopenia worsened and high fever continued. Blood culture results were negative for bacteral and fungal infection. After 10 days of treatment with antibiotics, G-CSF and blood transfusion, his pancytopenia showed improvement and the fever subsided. Not until 5 months after discontinuation of AZA did his pancytopenia fully recover.