Macrocytosis and pure RBC anemia caused by azathioprine
Y. A. DeClerck, R. B. Ettenger, J. A. Ortega and A. J. Pennisi
Red blood cell macrocytosis is a wellknown complication of azathioprine
therapy. In a group of 91 patients receiving azathioprine immunosuppressive
therapy for renal graft, the mean corpuscular volume determined by an
electronic cell counter was substantially higher than in the normal
population. Selective erythroid hypoplasia is another known but much less
frequent complication of azathioprine use. The case of a child who had a
selective erythroid hypoplasia while receiving azathioprine
immunosuppressive therapy for renal graft is reported. The patient
recovered as the drug therapy was discontinued. With progressive
reintroduction of the drug, a second decrease in the hemoglobin was seen
when a dose of 2 mg/kg was reached although with a smaller dose, no
recurrence of anemia was observed.
