Azathioprine hypersensitivity syndrome, a drug reaction mimicking sepsis

doi:N/A

eISSN: None / ISSN: None

Netharland Journal of Critical Care

2020, Volume 28, Issue 6 : 257-262

Article

Azathioprine hypersensitivity syndrome, a drug reaction mimicking sepsis

van den Hoven D.

Veldhuijzen N.

Röckmann H.

de Jong B.

⁴

Department of Emergency Medicine, Canisius Wilhelmina Hospital, Nijmegen, Netherlands

Department of Internal Medicine, Gelre Hospitals, Apeldoorn, Netherlands

Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, Netherlands

⁴

Department of Intensive Care Medicine, Hospital Group Twente, Almelo, Netherlands

Abstract

A 55-year-old male was admitted to hospital and later to the ICU with refractory distributive shock thought to be sepsis of unknown origin. Two days after discharge the patient was readmitted to the ICU with a generalised skin eruption and multiple organ dysfunction syndrome. Extended microbiological testing and CT scans were negative for an infection. Azathioprine hypersensitivity syndrome, characterised by systemic symptoms such as fever, nausea, vomiting, diarrhoea, arthralgias, myalgias, liver and/or renal involvement and even shock, was thought to be the most likely diagnosis. Early recognition of this syndrome and the discontinuation of azathioprine seems vitally important to prevent morbidity or even mortality. © 2020, Netherlands Society of Intensive Care. All rights reserved.

Keywords

Azathioprine hypersensitivity syndrome

Azathioprine-induced Sweet’s syndrome

Severe cutaneous adverse reactions

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