Drug Induced Myelosuppression and Alopecia Totalis in Ulcerative Colitis Patient: Unmasking the Enigma
Mohamad Sabsabee, Mira Almheiri*, Ehsan Malik and Anjan Madasu
ABSTRACT
Azathioprine and Sulfasalazine are common drugs used in various conditions including inflammatory bowel disease (IBD) to induce remission and control the disease. The common side effects reported are headache, gastrointestinal symptoms, pancreatitis and myelosuppression are with the use of both drugs. Significant pancytopenia associated with azathioprine use in patients with Thiopurine methyltransferase or NUDT15 mutations.
We report a case of severe pancytopenia and myelosuppression following treatment with sulfasalazine and Azathioprine in a patient with ulcerative colitis. Pancytopenia attributed to drugs combination in a setting of normal enzyme testing may hint to a drug interaction potentiating their side effect and toxicity.
