Saoji Vikrant V, Jawade Sugat A, Agrawal Piyush, Rimmalapudi Shravya
Department of Dermatology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India.
DDVL, Consultant Dermatologist, Skinzone, Raigarh, Chhattisgarh, India.
Indian J Dermatol. 2022 Jan-Feb;67(1):50-53. doi: 10.4103/ijd.ijd_249_21.
Azathioprine is an immunosuppressant used to treat several immunological disorders. As a purine analog, it inhibits DNA synthesis and cell multiplication. However, marrow suppression is a serious complication associated with azathioprine.
To analyze the marrow suppression caused by azathioprine in dermatology patients.
This is a retrospective analysis of the records of 18 patients who presented with marrow suppression secondary to azathioprine which was used for the treatment of various dermatological diseases.
The analysis includes 18 patients, 15 females and 3 males with the average age being 25.88 years. All except two patients received 1 mg/kg of oral azathioprine once daily. Leukopenia was seen in 13 patients (with severe leukopenia in 7 patients), thrombocytopenia in 8, and low hemoglobin in 14 patients. Isolated low hemoglobin was seen in four patients, isolated leukopenia in four patients, and only one patient presented with isolated thrombocytopenia. Six patients had pancytopenia. The duration from the starting dose to reporting of marrow suppression ranged from 10 days to 1 year. Eight out of 18 patients presented with anagen effluvium, 2 patients with oral ulcers, and 1 patient with an upper respiratory tract infection. All the patients recovered within 1 month.
Marrow suppression due to azathioprine can occur with a low dose of 1 mg/kg. Hair loss and oral ulcers serve as early warning signs for marrow suppression.
硫唑嘌呤是一种用于治疗多种免疫性疾病的免疫抑制剂。作为一种嘌呤类似物，它可抑制DNA合成和细胞增殖。然而，骨髓抑制是与硫唑嘌呤相关的一种严重并发症。
分析硫唑嘌呤在皮肤科患者中引起的骨髓抑制情况。
这是一项对18例因使用硫唑嘌呤治疗各种皮肤病继发骨髓抑制患者的记录进行的回顾性分析。
分析纳入18例患者，其中女性15例，男性3例，平均年龄25.88岁。除2例患者外，其余患者均接受每日1次、1mg/kg的口服硫唑嘌呤治疗。13例患者出现白细胞减少（7例为严重白细胞减少），8例出现血小板减少，14例出现血红蛋白降低。4例患者单纯血红蛋白降低，4例患者单纯白细胞减少，仅1例患者单纯血小板减少。6例患者出现全血细胞减少。从开始用药至报告骨髓抑制的时间为10天至1年。18例患者中有8例出现生长期脱发，2例出现口腔溃疡，1例出现上呼吸道感染。所有患者均在1个月内康复。
低剂量1mg/kg的硫唑嘌呤即可引起骨髓抑制。脱发和口腔溃疡是骨髓抑制的早期预警信号。
