HEMOLYTIC ANEMIA WITH INTRAVENOUS IMMUNOGLOBULIN IN IMMUNODEFICIENCY AND IMMUNE THROMBOCYTOPENIA: EFFECT OF ANTI-A DONOR SCREENING

Author(s):  
Hubsch Alphonse
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anup J. Devasia ◽  
Raveen Stephen Stallon Illangeswaran ◽  
Infencia Xavier Raj ◽  
Biju George ◽  
Poonkuzhali Balasubramanian

AbstractObjectivesAzathioprine (AZA) is a commonly used immunosuppressant in patients with autoimmune diseases. The toxic side effect to AZA (myelosuppression, hair loss, and oral ulcers) are highly unpredictable which can be life threatening if not identified earlier and dose adjustments made or the drug is withdrawn.Case presentationHere we report a case series of five patients with severe toxicity while on treatment with AZA for autoimmune hemolytic anemia (n=1) and Immune thrombocytopenia (n=4). The common thiopurine methyltransferase (TPMT) variants (TPMT*2, *3A, *3B) were not present in these patients. However, all these patients had the NUDT15 415C>T variant that has been reported to explain serious toxicity to thioguanine in Asian patients.ConclusionsOur report suggests pre-emptive genotype-based dosing of AZA could reduce adverse toxicity and hence better outcome.


2016 ◽  
Vol 58 (2) ◽  
pp. 216 ◽  
Author(s):  
Aysel Vehapoğlu ◽  
Nilüfer Göknar ◽  
Rümeysa Tuna ◽  
Fatma Betül Çakır

2020 ◽  
pp. jclinpath-2020-207037
Author(s):  
Siraj A Misbah ◽  
Mike F Murphy ◽  
Sue Pavord ◽  
Quentin Hill ◽  
Rob Coster ◽  
...  

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