Tương tác thuốc allopurinol và azathioprine nguy cơ ức chế tủy xương nặng: Báo cáo ca lâm sàng và điểm lại y văn

Abstract

Introduction: Drug interaction between allopurinol and azathioprine is a major severity, may be myelosuppresion including leukopenia, thrombocytopenia, anemia, may be delayed in onset have been reported in the literature. This drug interaction need to have management the risk of  myelosuppression when using them together. Case summary: Male patient, 63 years of age with a history of hypertension, type II diabetes mellitus for routine treatment with drugs, tuberculosis treated under national tuberculosis program and nephrotic syndrome complete with corticosteroid, added with azathioprine. On February 17, 2017, patients with periodic medical examination due to high uric acid index should be prescribed allopurinol. After one month of treatment, the patient was hospitalized with severe anemia because red blood cell, platelet and leukocyte counts reduced. After discontinuation of concomitant therapy, the blood parameters have been improved. Conclusion: This clinical case highlights the seriousness of the drug interaction between allopurinol and azathioprine and the potential for late suppression of bone marrow after concomitant. The risk of myelotoxicity can be reversed following discontinuation of drugs. Reduction of azathioprine dosage and closely haematological monitoring need to be considered when given concomitantly with allopurinol.