Haemolytic anaemia complicating the concurrent use of allopurinol & azathioprine after kidney transplantation

Authors

  • Catherine Hanna Department of Renal Medicine,Royal Infirmary of Edinburgh, 53 Little France Crescent,Edinburgh. EH16 4SA, UK
  • Neeraj Dhaun Department of Renal Medicine,Royal Infirmary of Edinburgh, 53 Little France Crescent,Edinburgh. EH16 4SA, UK
  • Maria Squires Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, 53 Little France Crescent, Edinburgh. EH16 4SA, UK
  • Simon Watson Department of Renal Medicine,Royal Infirmary of Edinburgh, 53 Little France Crescent,Edinburgh. EH16 4SA, UK

Keywords:

Allopurinol, Azathioprine, Transplantation, Haemolytic anemia

Abstract

Gout is a common problem in renal transplant recipients but often difficult to treat. Allopurinol can be combined with azathioprine but clinicians should be aware of the need for dose reduction, the potential to measure azathioprine breakdown products and the possible side effects of this combination. Leucopenia is a known side effect but this case report shows that haemolytic anaemia can also occur.

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References

Stamp L, Ha L, Searle M, O'Donnell J, Frampton C, Chapman P. Gout in renal transplant recipients. Nephrology (Carlton) 2006;11:367-71.

Haririan A, Nogueira J M, Zandi-Nejad K, Aiyer R, Hurley H, Cooper M, Klassen D K, Weir M R. The independent association between serum uric acid graft outcomes after kidney transplantation. Transplantation 2010;89:573-9.

Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008;359:1811-21.

Talaat KM, el-Sheikh AR. The effect of mild hyperuricemia on urinary transforming growth factor beta and the progression of chronic kidney disease. Am J Nephrol 2007;27:435-40.

Gearry RB, Day AS, Barclay ML, Leong RW, Sparrow MP. Azathioprine and allopurinol: A two-edged interaction. J Gastroenterol Hepatol 2010;25:653-5.

Zazgornik J, Hruby K, Schmidt P, Kopsa H, Pils P. Hemolysis after combined azathioprine and allopurinol therapy. Acta Med Austriaca 1979;6:197-9.

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Published

2017-01-30

How to Cite

Hanna, C., Dhaun, N., Squires, M., & Watson, S. (2017). Haemolytic anaemia complicating the concurrent use of allopurinol & azathioprine after kidney transplantation. International Journal of Basic & Clinical Pharmacology, 2(3), 330–332. Retrieved from https://www.ijbcp.com/index.php/ijbcp/article/view/1265

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Section

Case Reports