Pediatr Gastroenterol Hepatol Nutr.  2013 Sep;16(3):171-177. 10.5223/pghn.2013.16.3.171.

Adverse Events Associated with Azathioprine Treatment in Korean Pediatric Inflammatory Bowel Disease Patients

• Chun JY
• Kang B
• Lee YM
• Lee SY
• Kim MJ
• Choe YH

• KMID: 2051330
• DOI: http://doi.org/10.5223/pghn.2013.16.3.171

Abstract

PURPOSE
This study was aimed to evaluate the frequency and course of adverse events associated with azathioprine treatment in Korean pediatric patients with inflammatory bowel disease.
METHODS
Total of 174 pediatric patients (age range, 1 to 19 years) with inflammatory bowel disease who received azathioprine in order to maintain remission at Samsung Medical Center (Seoul, Korea) from January 2002 through December 2012 were included in this study. Medical records of these subjects were retrospectively reviewed regarding the development of adverse events associated with azathioprine treatment.
RESULTS
Ninety-eight patients (56.3%) of 174 patients experienced 136 episodes of adverse events, requiring dose reduction in 31 patients (17.8%), and discontinuation in 18 patients (10.3%). The mean dose of azathioprine that had been initially administered was 1.32+/-0.42 mg/kg/day. Among the adverse reactions, bone marrow suppression developed in 47 patients (27.0%), requiring dose reduction in 22 patients (12.6%) and discontinuation in 8 patients (4.6%). Other adverse events that occurred were gastrointestinal disturbance (15.5%), hair loss (12.1%), pancreatitis (7.5%), arthralgia (6.9%), hepatotoxicity (2.9%), skin rash/allergic reactions (2.9%), headache/dizziness (2.3%), sepsis (0.6%), and oral mucositis (0.6%).
CONCLUSION
Bone marrow suppression, especially leukopenia was most commonly associated with azathioprine treatment in Korean pediatric inflammatory bowel disease patients. Close observation for possible adverse events is required in this population with inflammatory bowel diseases who are under treatment with azathioprine.

Keyword

Inflammatory bowel diseases; Crohn disease; Ulcerative colitis; Azathioprine; Adverse reactions; Bone marrow suppression; Leukopenia

MeSH Terms

Arthralgia
Azathioprine
Bone Marrow
Colitis, Ulcerative
Crohn Disease
Hair
Humans
Inflammatory Bowel Diseases
Leukopenia
Medical Records
Pancreatitis
Retrospective Studies
Sepsis
Skin
Stomatitis
Azathioprine

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