formication associated with azathioprine therapy: first report
TRANSCRIPT
FORMICATION ASSOCIATED WITH AZATHIOPRINE THERAPY: First Report
... A Sensation of Ants Crawling Over the Skin, Probably a Hypersensitivity ReactionA 56-year-old white woman with chronic renal failure due to chronic nephritis, developed chronic active hepatitis after 4 monthshaemodialysis. Liver tests normalised on 20mglday prednisone. Six-months later, as serum glucose was 165mgldl, the dose ofprednisone was reduced to IOmgI day. and 50mg I day azathioprine ('Imuran', Burroughs Wellcome) added to the regimen. Threedays later she complained-of a sensation ofants crawling allover the body (formication). Azathioprine Wasstopped. Formicationsymptoms disappeared within 12 hours. Three weeks later, on reintroduction ofazathioprine, formication recurred within 12hours. The drug was stopped and she continued on prednisone 20mg/day. Four days later azathioprine was reintroduced, andwithin 12 hours formication recurred, associated with generalised urticaria and eosinophilia, difficulty in swallowing, andswollen eyelids, suggesting a hypersensitivity reaction to azathioprine or its metabolic derivatives. The patient is now symptomfree on maintenance prednisone 20mg/day.Brandt. LJ.: Annals oflnternal Medicine 87: 458 (Oct 1977)
INPHARMA 12th November, 1977 p5