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Treatment of gout in a renal transplant patient leading to severe thrombocytopenia
Author(s) -
Weiler S.,
Aellig N.,
Fauchère I.,
Jetter A.,
Corti N.
Publication year - 2014
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12190
Subject(s) - allopurinol , discontinuation , azathioprine , medicine , xanthine oxidase , gout , platelet , drug , renal transplant , combination therapy , drug interaction , pharmacology , metabolite , gastroenterology , kidney , chemistry , enzyme , biochemistry , disease
Summary What is known and objective Allopurinol ( AP ) inhibits the xanthine oxidase, which may indirectly lead to myelotoxicity when used in combination with azathioprine ( AZA ). Case summary A 79‐year‐old female developed symptomatic thrombocytopenia after combination therapy with AZA (75 mg/day) and AP (100 mg/day) – after AP had been stopped. Concentrations of the myelotoxic 6‐thioguanine‐nucleotides metabolite of AZA were increased. Thrombocyte counts normalized within 8 days of discontinuation of AZA . What is new and conclusion The effect of a drug interaction in a patient with decreased elimination capacity may take several weeks to become apparent and may in fact do so even after the drug has been stopped. Concurrent AZA and AP therapy demands cautious use.