ArticlePloS one2016
The Impact of Azathioprine-Associated Lymphopenia on the Onset of Opportunistic Infections in Patients with Inflammatory Bowel Disease.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Comparative Risk of Serious Infections With Biologic and/or Immunosuppressive Therapy in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Pooled it
- Pooled it
- Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance.Military Medical Research · 2026Review
- Assessment of Azathioprine-Associated Lymphopenia Incidence Rates in Polish Children with Inflammatory Bowel Disease and Autoimmune Hepatitis: A Retrospective Study.Children (Basel, Switzerland) · 2025Article
- Cytotoxic Molecules as Potential Biomarkers for Active and Inactive Systemic Lupus Erythematosus.Biomedicines · 2025Article
- Genetic association analysis and frequency of NUDT15*3 with thiopurine-induced myelosuppression in patients with inflammatory bowel disease in a large Dutch cohort.The pharmacogenomics journal · 2024Article
- Precision medicine in monogenic inflammatory bowel disease: proposed mIBD REPORT standards.Nature reviews. Gastroenterology & hepatology · 2023Review
- Evaluation of the mTORC activity in the presence of Toxoplasma gondii and azathioprine in human monocyte cell line.BMC microbiology · 2023Article
- Cytomegalovirus Pneumonia in Inflammatory Bowel Disease: Literature Review and Clinical Recommendations.Infection and drug resistance · 2023Review
- Common infections, mental health problems and healthcare use in people with inflammatory bowel disease: a cohort study protocol.Evidence-based mental health · 2021Article
- Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study.BMJ open gastroenterology · 2021Article
- The complex relationship between viruses and inflammatory bowel disease - review and practical advices for the daily clinical decision-making during the SARS-CoV-2 pandemic.Therapeutic advances in gastroenterology · 2021Review
- Coronavirus Disease 2019 in Autoimmune Hepatitis: A Lesson From Immunosuppressed Patients.Hepatology communications · 2020Article
- Immunotherapy for ANCA-associated vasculitis during the COVID-19 pandemic.European journal of rheumatology · 2020Article
- Immunosuppressive agents for dermatological indications in the ongoing COVID-19 pandemic: Rationalizing use and clinical applicability.Dermatologic therapy · 2020Review
- Consensus Statement On Immune Modulation in Multiple Sclerosis and Related Disorders During the COVID-19 Pandemic: Expert Group on Behalf of the Indian Academy of Neurology.Annals of Indian Academy of Neurology · 2020Article
- Clinical assessment of risk factors for infection in inflammatory bowel disease patients.International journal of colorectal disease · 2020Article
- The Evolving Role of Thiopurines in Inflammatory Bowel Disease.Current treatment options in gastroenterology · 2019Review
- The Evolving Role of Thiopurines in Inflammatory Bowel Disease.Current treatment options in gastroenterology · 2019Review
- BAFF-driven B cell hyperplasia underlies lung disease in common variable immunodeficiency.JCI insight · 2019Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThiopurines are known to cause lymphopenia (<1,500 lymphocytes/μl). As severe lymphopenia (<500C/μl) is associated with opportunistic infections, we investigated severity of thiopurine-related lymphopenia and development of opportunistic infections in our tertiary referral centre.
methodsWe retrospectively screened medical records of 1,070 IBD patients and identified 100 individuals that developed a total of 161 episodes of lymphopenia during thiopurine treatment between 2002 and 2014. Occurrence of opportunistic infections was documented. A control group consisted of IBD patients receiving thiopurines but without developing lymphopenia.
resultsOf a total of 161 episodes of lymphopenia, 23% were severe (<500C/μl). In this subgroup, thiopurine dosing was modified in 64% (dosage reduction: 32%, medication discontinued: 32%). We identified 9 cases (5.5%) of opportunistic infections, of which only two occurred during severe lymphopenia. One opportunistic infection (4.5%) was identified in the control group. No association was found between opportunistic infections and severity of lymphopenia. All patients who suffered from opportunistic infections were receiving additional immunosuppressive medication.
conclusionOur patients treated with thiopurines rarely developed severe lymphopenia and opportunistic infections did not occur more often than in the control group. A careful monitoring of lymphocytes and prophylactic adjustment of thiopurine therapy might contribute to this low incidence.
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