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

dc.contributor.authorSu, Samuel
dc.contributor.authorWang, Yu M.
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.abstractAbstract Background 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.urihttps://doi.org/10.1186/s13223-024-00906-7
dc.identifier.urihttp://hdl.handle.net/1993/38366
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleSevere distributive shock, neutrophilic dermatosis, and ST-elevation myocardial infarction in the setting of azathioprine hypersensitivity syndrome
dc.typeJournal Article
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