Severe distributive shock, neutrophilic dermatosis, and ST-elevation myocardial infarction in the setting of azathioprine hypersensitivity syndrome

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dc.contributor.authorSu, Samuel
dc.contributor.authorWang, Yu Ming
dc.contributor.authorZaborniak, Karver
dc.contributor.authorHamza, Sate
dc.contributor.authorJassal, Davinder S
dc.contributor.authorBlouw, Marcus
dc.date.accessioned2024-08-06T19:07:39Z
dc.date.available2024-08-06T19:07:39Z
dc.date.issued2024-07-20
dc.date.updated2024-08-01T03:37:11Z
dc.description.abstractBackground Azathioprine is a purine synthesis inhibitor used as an immunosuppressive therapy for many immune-mediated diseases. Azathioprine hypersensitivity reaction is a rare, life-threatening adverse reaction characterized by a range of multisystem manifestations including fever, abdominal pain, arthralgias, erythematous cutaneous eruption, acute renal failure, neutrophilia, and more rarely, distributive shock. Although acute heart failure has been rarely described in association with azathioprine hypersensitivity syndrome, myocardial infarction has, to our knowledge, never been associated with this entity. Case Presentation We describe a case of a 59-year-old male with Crohn’s disease who developed severe azathioprine hypersensitivity syndrome that included distributive shock, neutrophilic dermatosis, and acute coronary syndrome with ST-elevation. Clinical improvement was seen after cessation of azathioprine and administration of glucocorticoid therapy. Conclusion Prompt recognition of azathioprine hypersensitivity syndrome, which can manifest as shock and neutrophilic dermatosis, is key to ensure rapid azathioprine cessation.
dc.identifier.citationAllergy, Asthma & Clinical Immunology. 2024 Jul 20;20(1):39
dc.identifier.doi10.1186/s13223-024-00906-7
dc.identifier.urihttp://hdl.handle.net/1993/38366
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectAzathioprine
dc.subjectHypersensitivity
dc.subjectST-elevation myocardial infarction
dc.titleSevere distributive shock, neutrophilic dermatosis, and ST-elevation myocardial infarction in the setting of azathioprine hypersensitivity syndrome
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Internal Medicine
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Pathology
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Physiology and Pathophysiology
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Radiology
oaire.citation.issue39
oaire.citation.titleAllergy, Asthma & Clinical Immunology
oaire.citation.volume20
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