Severe Myelosuppression Following Alopecia Shortly after the Initiation of 6-Mercaptopurine in a Patient with Crohn's Disease

Takuhiro Ugajin; Hiroyuki Miyatani; Toshio Demitsu; Takaaki Iwaki; Shinya Ushimaru; Yoshiyuki Nakashima; Yukio Yoshida

doi:10.2169/internalmedicine.48.1736

CASE REPORTS

Severe Myelosuppression Following Alopecia Shortly after the Initiation of 6-Mercaptopurine in a Patient with Crohn's Disease

Takuhiro Ugajin, Hiroyuki Miyatani, Toshio Demitsu, Takaaki Iwaki, Shinya Ushimaru, Yoshiyuki Nakashima, Yukio Yoshida

Author information

Keywords: Crohn's disease, 6-mercaptopurine, myelosuppression, alopecia, TPMT

JOURNAL OPEN ACCESS

2009 Volume 48 Issue 9 Pages 693-695

DOI https://doi.org/10.2169/internalmedicine.48.1736

Details

Abstract

A 15-year-old, woman, Crohn's disease patient, who carried the TPMT *3C heterozygous mutant, complained of alopecia 3 days after starting 6-mercaptopurine (6-MP) and then developed severe myelosuppression 6 weeks after starting 6-MP. The alopecia involved scalp hair only (body hair preserved) and was dominant in the temporal region. Following these side effects, transient remission of Crohn's disease occurred. Myelosuppression due to 6-MP is a rare but life-threatening side effect that is difficult to predict despite continuous monitoring of complete blood cell counts. In the present case, 6-MP-induced alopecia preceded myelosuppression and progressed rapidly as the myelosuppression worsened.

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