Pancytopenia in neuromyelitis optica spectrum disorder induced by azathioprine-allopurinol interaction

Cesar D. Bautista-Sanchez , Luis E. Martínez-Bravo , Diego A. Hidalgo-Díaz
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Abstract

Background

Azathioprine (AZA) remains a widely used treatment for neuromyelitis optica spectrum disorder (NMOSD). It heightens the risk of myelosuppression, a risk further intensified with the addition of allopurinol.

Case presentation

To the best of our knowledge, there have been no reported cases of this complication in NMOSD.

Case report

We present a 63-year-old female with NMOSD on AZA, who experienced severe myelosuppression upon initiating allopurinol. Following the discontinuation of these drugs, we prescribed granulocyte stimulants, recombinant erythropoietin, and supportive care, which resulted in hematologic improvement.

Conclusions

This case highlights a potential myelosuppression risk when combining AZA and allopurinol in NMOSD patients.

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硫唑嘌呤-阿洛嘌呤醇相互作用诱发的神经性脊髓炎视网膜频谱紊乱全血细胞减少症
背景硫唑嘌呤(AZA)仍是神经脊髓炎视网膜频谱紊乱症(NMOSD)的一种广泛使用的治疗方法。病例报告据我们所知,目前还没有关于 NMOSD 并发症的病例报告。我们为您介绍一位 63 岁的女性 NMOSD 患者,她正在服用 AZA,在开始服用别嘌呤醇后出现了严重的骨髓抑制。停用这些药物后,我们处方了粒细胞刺激剂、重组促红细胞生成素和支持性护理,结果血液学状况有所改善。结论本病例强调了 NMOSD 患者联合使用 AZA 和别嘌呤醇时可能存在骨髓抑制的风险。
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