Alopecia as an Early Clinical Marker for Azathioprine Induced Myelosuppression: A Case Report

Authors

Nilanjana Dutta , Final Year MBBS, JSS Medical College and Hospital, JSS Academy of Higher Education and ResearchFollow
Dr. M Suresh Babu , Professor, Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and ResearchFollow
Dr. Subramanian Ramaswamy , Professor, Department of Clinical Immunology and Rheumatology, JSS Medical College and Hospital, JSS Academy of Higher Education and ResearchFollow
Dr. Mahabaleshwar Mamadapur , Assistant Professor, Department of Clinical Immunology and Rheumatology, JSS Medical College and Hsopital, JSS Academy of Higher Education and ReseachFollow

Author ORCID Identifier

https://orcid.org/my-orcid?orcid=0000-0001-7421-2418

Corresponding Author

Dr. Mahabaleshwar Mamadapur,

Assistant Professor, Department of Clinical Immunology and Rheumatology JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore

email: mahabaleshwarm@jssuni.edu.in

Abstract

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for possible gene mutations.

Publication Date

2024

Publisher

JSS Academy of Higher Education and Research

Conflict of Interest

None

Keywords

Azathioprine, Alopecia, Myelosuppression, NUDT15, TPMT

Word Count

974

Recommended Citation

Dutta N , Final Year MBBS, Babu D , Professor, Ramaswamy D , Professor, Mamadapur D , Assistant Professor. Alopecia as an Early Clinical Marker for Azathioprine Induced Myelosuppression: A Case Report. Digital Journal of Clinical Medicine. 2024; 6(1): -. doi: https://doi.org/10.55691/2582-3868.1173

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.