Azathioprine-Induced Agranulocytosis and Severe Alopecia After Kidney Transplantation Associated With a NUDT15 Polymorphism: A Case Report

    December 2018 in “ Transplantation proceedings ”
    Ken Saida, Koichi Kamei, Masao Ogura, Sohshi Matsumura, Yuji Kano, Miori Sato, Akira Andoh, Kenji Ishikura
    TLDR A woman experienced severe side effects from a drug due to a specific genetic variation, suggesting genetic testing could prevent such risks.
    This case report described a 37-year-old woman who experienced azathioprine-induced agranulocytosis and severe alopecia after a kidney transplant, which was linked to a NUDT15 polymorphism (rs116855232, p.Arg139Cys). The patient had stable renal function post-transplant and was on a triple-immunosuppressant regimen. The NUDT15 polymorphism was identified through genome-wide correlation analysis, marking this as the first reported case of such adverse effects in a kidney transplant patient with this genetic variant.
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