Azathioprine Hypersensitivity Presenting as Cardiogenic Shock and Sweet's Syndrome in a Patient with Microscopic Polyangiitis

Arthur Turow; Tuck Y Yong; Jie Shen Fok; Jordan YZ Li

doi:10.2169/internalmedicine.51.6962

CASE REPORTS

Azathioprine Hypersensitivity Presenting as Cardiogenic Shock and Sweet's Syndrome in a Patient with Microscopic Polyangiitis

Arthur Turow, Tuck Y Yong, Jie Shen Fok, Jordan YZ Li

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Keywords: azathioprine, cardiogenic shock, congestive heart failure, hypersensitivity, microscopic polyangiitis, Sweet's syndrome

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 14 Pages 1889-1892

DOI https://doi.org/10.2169/internalmedicine.51.6962

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Abstract

Azathioprine hypersensitivity is a clinical syndrome which may manifest from isolated fever and rash to multi-organ failure. This rare condition is usually self-limiting following the discontinuation of azathioprine. Therefore, it is important to maintain a high index of clinical suspicion for hypersensitivity reactions with azathioprine therapy. We report a case of azathioprine hypersensitivity in a 69-year-old woman who developed cardiogenic shock and Sweet's syndrome following the initiation of azathioprine for her underlying autoantibodies to neutrophil cytoplasmic antigens (ANCA) associated microscopic polyangiitis.

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