Azathioprine Hypersensitivity Syndrome

Frank, James A.; Fett, Nicole

doi:10.3899/jrheum.170066

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…Given the mortality with azathioprine‐induced hypersensitivity, cutaneous and systemic manifestations respond well with stoppage of the drug alone and conservative management with intravenous fluids in the case of vascular collapse—complete resolution of manifestations noted within a week. Rechallenges with azathioprine had previously resulted in an increased risk of mortality and morbidity 9 …”

Section: Discussionmentioning

confidence: 99%

Azathioprine hypersensitivity: A Sweet‐like syndrome

Sivanandam,

Begum,

Martinez

et al. 2023

Int J of Rheum Dis

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IntroductionAzathioprine hypersensitivity can occasionally present as Sweet‐like syndrome, a dose‐independent side effect characterized by the unanticipated onset of macules, papules, and pustules.Case presentationA 35‐year‐old woman with systemic lupus erythematosus presented with complaints of generalized maculopapular rash, facial swelling, and bilateral lower extremity edema with a duration of 4 days and a 2‐day history of constitutional symptoms within 2 weeks of the beginning of azathioprine therapy to treat existing lupus nephritis (class 2/3).DiscussionPatients who experience azathioprine hypersensitivity syndrome can present with erythema nodosum, small‐vessel vasculitis, acute generalized exanthematous pustulosis, Sweet syndrome, and nonspecific dermatosis. The following signs and symptoms are used as criteria to diagnose drug‐induced Sweet syndrome: (a) abrupt onset of painful erythematous plaques, (b) histopathological evidence of dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis, (c) temperature higher than 39.7°C, (d) temporal relationship between drug ingestion and clinical presentation, and (e) temporal resolution of lesions after drug withdrawal. Our patient met three out of five criteria and was diagnosed with Sweet‐like syndrome.ConclusionOur case highlights the uncommonly presented azathioprine‐induced Sweet‐like syndrome that occurs abruptly after the commencement of the offending drug. This diagnosis can be established through basic laboratory workup and skin biopsy findings.

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Section: Discussionmentioning

confidence: 99%

Azathioprine hypersensitivity: A Sweet‐like syndrome

Sivanandam,

Begum,

Martinez

et al. 2023

Int J of Rheum Dis

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“…Klinische und paraklinische Hauptmanifestationen und ihre Inzidenzen (%) beim Azathioprin-Hypersensitivitätssyndrom (AHS) (nach[2][3][4]). Nebenwirkungen von Azathioprin (nach Swissmedicinfo.ch und[6]).…”

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Eine Sepsis, die skeptisch macht

Cisarovsky¹,

Gautier

Ribi³

et al. 2021

Swiss Med Forum

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Centre hospitalier universitaire vaudois (CHUV), Lausanne: a Service de de médecine interne, Département de médecine; b Service d'anesthésie; c Service d'immunologie et allergie, Département des Laboratoires * Diese Autoren haben zu gleichen Teilen zum Artikel beigetragen. Fallbeschreibung Ein 50-jähriger Patient stellt sich mit seit einem Monat bestehender Abgeschlagenheit und vor 24 Stunden hinzugekommenem Fieber bis 39 °C und Schüttelfrost vor. Er berichtet von einem Hundebiss und Kratzverletzungen durch Dornen, die er sich erst kürzlich zugezogen habe. Seit einem Jahr trägt er eine unikompartimentelle Kniegelenksprothese links, ausserdem hat er aufgrund einer Rotatorenmanschettenverletzung vor 15 Tagen eine Kortikoidinfiltration erhalten. Vor drei

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Cutaneous Side Effects of Immunosuppressive Drugs Other Than Neoplasms

Miotto

Oliveira

2022

Atlas of Dermatologic Diseases in Solid Organ Transplant Recipients

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Azathioprine Hypersensitivity Syndrome

Cited by 6 publications

References 4 publications

Azathioprine hypersensitivity: A Sweet‐like syndrome

Azathioprine hypersensitivity: A Sweet‐like syndrome

Eine Sepsis, die skeptisch macht

Cutaneous Side Effects of Immunosuppressive Drugs Other Than Neoplasms

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