One Case of Bone Marrow Suppression Caused by Azathioprine Tablets in a Patient with TPMT Heterozygous Mutation

doi:10.19803/j.1672-8629.20240451

Abstract

Abstract: Objective To analyze the cause of bone marrow suppression in a patient with a TPMT gene mutation after treatment with azathioprine. Methods By using pyrophosphate sequencing genetic testing, international guidelines and literature review, the etiology of one case of bone marrow suppression was studied. Results The patient was identified as a heterozygote for the *1/*3C allele at the TPMT gene locus, which was associated with an elevated risk of azathioprine-induced bone marrow suppression. The patient was recommended to reduce the dosage of azathioprine and undergo vigilant monitoring. Upon cessation of azathioprine and initiation of symptomatic treatment, the bone marrow suppression of the patient improved after 27 days. Conclusion Mutations in TPMT can predispose individuals to heightened risks of adverse reactions to azathioprine. During azathioprine therapy, it is imperative to closely monitor hematological indices and other clinical parameters. When feasible, genetic testing should be conducted to preemptively gauge the risk of adverse reactions, thereby facilitating personalized medication adjustments to enhance treatment safety.

Key words: Azathioprine, Bone Marrow Suppression, Polymorphism, TPMT, Mutation, Adverse Drug Reaction, Safety

CLC Number:

HU Kun, HUANG Weiguo, LEI Lili, PANG Xiaocong, ZHOU Ying, CUI Yimin. One Case of Bone Marrow Suppression Caused by Azathioprine Tablets in a Patient with TPMT Heterozygous Mutation[J]. Chinese Journal of Pharmacovigilance, 2025, 22(3): 337-340.

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https://zgywjj.magtechjournal.com/EN/Y2025/V22/I3/337

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