ArticleJPGN reports2026
Nudix hydrolase 15 deficiency and azathioprine toxicity in a liver transplant recipient: A case report.
Article in JPGN reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Thiopurines, such as azathioprine (AZA), are among the immunosuppressants used to prevent allograft rejection. Thiopurines are metabolized by thiopurine S-methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15) enzymes, and their functions are highly influenced by genetic variation. We present a 6-year-old female with recurrent acute cellular rejection and steroid-induced glaucoma due to high-dose corticosteroid therapy. Consequently, AZA was incorporated into her calcineurin-inhibitor-based regimen to reduce steroid dose. Within 33 days of initiating AZA, alopecia and pancytopenia developed despite confirmed TPMT enzyme activity with normal phenotype and low 6-Thioguanine and 6-Methylmercaptopurine levels in the blood. Pharmacogenomic analysis revealed an
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