Azathioprine-Associated Complete NK Cell Deficiency

Azathioprine-Associated Complete NK Cell Deficiency J Clin Immunol (2017) 37:514–516 DOI 10.1007/s10875-017-0414-6 LETTER TO EDITOR 1 2 1 3 Amir B. Orandi & Tiphanie P. Vogel & Molly P. Keppel & Elizabeth C. Utterson & 1,4 Megan A. Cooper Received: 3 April 2017 /Accepted: 15 June 2017 /Published online: 22 June 2017 Springer Science+Business Media, LLC 2017 To the editor, respectively. She was subsequently treated with corticoste- We report the case of a 5-year-old Caucasian girl with very roids and azathioprine, with testing demonstrating wildtype early-onset inflammatory bowel disease (VOIBD) who had thiopurine methyltransferase genotype, predictive of normal inadequate response to initial therapy with azathioprine. azathioprine metabolism. Over the ensuing 12 months, she continued to have active disease and azathioprine was incre- Immune system evaluation revealed an isolated complete nat- ural killer cell (NK cell) deficiency, which resolved with dis- mentally increased to 3 mg/kg. Drug levels at this dose continuation of the drug. showed sub-therapeutic 6-TGN at 229 pmol/RBC (range The patient first presented at age 4 with a history of angular 230–400), below risk levels for myelotoxicity with no eleva- cheilitis and oral ulcerations of the soft palate. She had notable tion of the hepatotoxic metabolite 6-MMPN. findings of microcytic anemia (Hb Journal of Clinical Immunology Springer Journals

Azathioprine-Associated Complete NK Cell Deficiency

Loading next page...
Springer US
Copyright © 2017 by Springer Science+Business Media, LLC
Biomedicine; Immunology; Infectious Diseases; Internal Medicine; Medical Microbiology
Publisher site
See Article on Publisher Site


You’re reading a free preview. Subscribe to read the entire article.

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches


Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.



billed annually
Start Free Trial

14-day Free Trial