Infliximab- and azathioprine-related severe neutropenia and thrombocytopenia in a case with Crohn's disease.

Abstract

A 25-year-old female patient with Crohn's disease had been using azathioprine and metronidazole for an extended period because of recurrent perianal and rectovaginal fistulae. Infliximab was added to the treatment regimen following postoperative recurrence of a rectovaginal fistula. Upon the development of severe neutropenia and thrombocytopenia after the third dose of infliximab, azathioprine and infliximab were stopped. Neutropenia work-up did not reveal any other cause. Neutropenia was ameliorated with use of granulocyte colony-stimulating factor. Treatment was restarted with infliximab alone upon leakage from the rectovaginal fistula with no hematologic toxicity. This case was considered as a serious adverse effect of infliximab and azathioprine combination therapy.

• Authors: Ali Rıza Köksal, Canan Alkim, Engin Altinkaya, Mehmet Sait Buğdaci, Osman Özdoğan, Salih Boğa, Hüseyin Alkim, Mehmet Sökmen
• Journal: The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology (Turk J Gastroenterol) Vol. 22 Issue 5 Pg. 537-9 (Oct 2011) ISSN: 2148-5607 [Electronic] Turkey
• PMID: 22234764 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Infective Agents
• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Immunosuppressive Agents
• Metronidazole
• Granulocyte Colony-Stimulating Factor
• Infliximab
• Azathioprine

Topics

• Adult
• Anti-Infective Agents (administration & dosage)
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Antibodies, Monoclonal (administration & dosage, adverse effects)
• Azathioprine (administration & dosage, adverse effects)
• Crohn Disease (drug therapy)
• Drug Therapy, Combination
• Female
• Granulocyte Colony-Stimulating Factor (administration & dosage)
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Infliximab
• Metronidazole (administration & dosage)
• Neutropenia (chemically induced, drug therapy)
• Thrombocytopenia (chemically induced, drug therapy)