Azathioprine (Aza) - Unable to tolerate (leukopenia) | Lupus Forums at The Lupus Site
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Azathioprine (Aza) - Unable to tolerate (leukopenia)

Discussion in 'Cytotoxic / immunosuppressives' started by chewy, Jan 30, 2010.

  1. chewy

    chewy Guest

    Jan-2006 - Hospitalised due to Fever, Leukopenia. Responded well to IV dose of steroid.

    Between Jan-Sep 2006 - Mild flare, arthritis pain, fever, persistently low C3,C4 - clinically well with low-moderate dose of oral steroid adjustments

    Jul-2006 - Introduced Aza 50mg.

    Oct-2006 - Hospitalised due to fever, pancytopenia (platelet dropped to 34,000/cmm (normal : 150,000 - 400,000) - Took off Aza upon hospitalisation. Responded moderately to IV solumedrol 125mg IV every 6 hrs.

    Oct-Nov 2006 - Continued hospitalisation (different hospital) - more IV steroid - responded moderately.

    Nov 2006 - Bone Marrow Aspiration (results : no abnomalies found)

    Nov-2006 - Discharged with low but stable platelet, 40mg preds OD.

    Dec-2006 to Jan-2007 - Reintroduced Aza @ 50mg daily, taper pred to 35mg, then 25mg

    Late Jan-2007 to Mar-2007 - Increased Aza @ 50mg twice a day = 100mg, taper pred to 20, 17.5, 15, 12.5 mg

    Apr-2007 to Sep-2007 - Increased Aza @ 75mg morning, 50mg night = 125mg, taper pred to 10, 7.5 mg

    Oct-2007 to Dec-2007 - Oct-07 WBC down to 2.8, Aza @ 75mg morning, 50mg night = 125mg, up pred 30, 25, 20 mg
    (WBC normalised @ pred 30, 25 but went down to 3.04 on 20mg)

    7-Jan-2008 – Rheumy initiated IV Methlypred 250mg IV @ ward

    Jan-2008 – Mid Mar-2008 - Increased Aza @ 100mg morning, 50mg night = 150mg, pred taper 20, 17.5, 15, 12.5, 10mg
    (WBC Mid Mar-2008 : 4.11)

    Mid Mar-2008 to Mid May-2008 – Aza @ 100mg morning, 50mg night = 175mg, pred remained 10mg
    (WBC Mid May-2008 : 3.55)

    Mid Jul-2008 – Mid Aug-2008 – Off Aza, preds up to 20mg
    (WBC Mid Jul-2008 : 2.56)

    Mid Aug-2008 – Mid Sep-2008 – Re-challenged Aza @ 75mg daily, taper preds to 15, 10mg
    (WBC Mid Aug-2008 : 6.5)

    Mid Sep-2008 – Off Aza, preds remained 10mg
    (WBC Mid Sep-2008 : 3.84)

    Late Oct-2008 – Mid Mar-2009 – Taper preds 10, 7.5mg
    Mid Mar-2009 – Jan-2010 – Taper to 5 mg
    (WBC Jun-09 : 5.79)
    (WBC Sep-09 : 4.07)
    (WBC Nov-09 : 6.81)

    The rheumatologist(s) came to a conclusion that I was not able to tolerate Azathioprine, which was re-challenged twice.
     
    Last edited by a moderator: Oct 3, 2014

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