Azathioprine-Induced Severe Myelosuppression Accompanied by Massive Hair Loss and Painful Oral Ulcer in an Autoimmune Hepatitis Patient with NUDT15 Minor Variant: A Case Report

    August 2021 in “ Clinical Case Reports ”
    Yu Takeuchi, Hidenao Noritake, Masako Matsumoto, Masahiro Umemura, M. Yamashita, Kensuke Kitsugi, Shingo Takatori, Kazuyoshi Ohta, Jun Ito, Shin Shimoyama, Akira Kaysuya, Chiaki Maruyama, Kazuki Fukuchi, Satoshi Dohtan, Hiroe Sakata, Kazuhito Kawata
    TLDR Genetic testing is crucial before giving azathioprine to avoid severe side effects.
    A case report from August 2021 described a patient with autoimmune hepatitis who experienced severe myelosuppression, massive hair loss, and painful oral ulcers after being treated with azathioprine. The patient had a minor variant of the NUDT15 gene, which is known to increase susceptibility to azathioprine-induced toxicity. This case underscored the importance of genetic testing before administering azathioprine to prevent such severe adverse reactions.
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