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This case report details severe hematological toxicity and fatal complications from azathioprine in a patient with Crohn's disease with a homozygous NUDT 15 variant, suggesting pharmacogenomic testing before treatment.

In this study, a case of a young Chinese female with a specific NUDT15 genetic variant experienced severe azathioprine-induced myelosuppression and alopecia while treating systemic lupus erythematosus, highlighting the need for routine blood monitoring during treatment to manage AZA intolerance associated with genetic factors.

This study found that among Japanese IBD patients, the NUDT15 p.Arg139Cys variant was significantly associated with thiopurine-induced leukopenia and severe hair loss, suggesting its genotyping is important for predicting these adverse events.

This review examines the role of thiopurines in managing inflammatory bowel diseases like ulcerative colitis and Crohn's disease, and reports no new clinical results, emphasizing the need for more studies on thiopurine withdrawal scenarios.

This study reported that the NUDT15 R139C genetic variant was significantly associated with thiopurine-induced leukocytopenia in Japanese inflammatory bowel disease patients, independent of 6-thioguanine nucleotide levels.