Description
A 46 year old man weighing 114kg was admitted with a three day history of fevers and cough productive of yellow sputum. He had a past medical history of extensive ulcerative colitis with seronegative arthropathy, duodenal ulcer and hypertension. The previous year the removal of an acoustic neuroma was complicated by meningitis. He had been started on azathioprine for ulcerative colitis 10 months prior to admissinon, initially tolerating a dose 100mg once daily without evidence of bone marrow suppression. Five months prior to admission the dose had been increased to 150mg once daily, and six weeks later his white cell count had started to fall. Thus azathioprine was initially reduced and then stopped because of a neutropenia.
