Pancytopenia caused by allopurinol and azathioprine interaction in a heart transplant patient: a case report.

ABSTRACT:

Background

Azathioprine is an immunosuppressive now less commonly prescribed after orthotopic heart transplantation. Patients with solid organ transplantation are at increased risk for numerous comorbidities including gout. Co-administration of allopurinol for gout prophylaxis and azathioprine increases the risk for severe myelosuppression due to drug-drug interactions.

Case summary

A 57-year-old male with a history of heart transplant 6 years prior presented with a month of severe fatigue and shortness of breath. His admission laboratory values were notable for severe pancytopenia. Medical workup revealed no haematologic malignancy, viral infection, or other consumptive process. After extensive review, it was discovered that the patient was taking excessive allopurinol for

SUBMITTER: Feinman J 

PROVIDER: S-EPMC7793128 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature