azathioprine / Generic mfg. - LARVOL DELTA

Pulmonary Hypertension in a Parturient Complicated by Right Ventricular Failure​ (ASA 2025) - "Despite steroids, azathioprine, and respiratory support, her condition worsened, leading to preterm labor, intubation, and emergency C-section...Resuscitative efforts, including CPR and vasopressors, failed, and she passed away after being transitioned to comfort care. This case highlights the high maternal risk PH poses during pregnancy and underscores the need for early intervention, multidisciplinary care, and further research to improve outcomes in such high-risk cases."

Cardiovascular • Congestive Heart Failure • Heart Failure • Immunology • Metabolic Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Sarcoidosis

Post-Operative Stridor in an Asymptomatic Myasthenia Gravis Patient After Sugamaddex Reversal Treated with Neostigmine (ASA 2025) - "He had general anesthesia with rocuronium for paralysis and sugammadex for reversal. Elderly male with history of myasthenia gravis (diagnosed 2011 - recently weaned off of Azathioprine) who underwent thyroidectomy (2014) and found to have vocal cord paralysis with bowing. He was scheduled for microlaryngoscopy with injection of calcium hydroxylapatite due to worsening dysphonia. PACU course was complicated by stridor that partially responded to racemic epinephrine and lidocaine nebulizers. There was concern for myasthenic crisis, so he was challenged with neostigmine/glycopyrrolate, which significantly improved his voice strength and oxygen requirement. Consider acetylcholinesterase inhibitors for inadequate reversal of myasthenia gravis patients."

Clinical • Anesthesia • CNS Disorders • Dysphonia • Myasthenia Gravis

When Less Could be More: Successful Treatment of Granulomatous Lymphocytic Interstitial Lung Disease with Azathioprine. (PubMed, Eur J Case Rep Intern Med) - "There are no guidelines based on randomized controlled studies on the treatment of patients with common variable immunodeficiency and interstitial lung disease.The use of rituximab in the treatment of various non-infectious manifestations in patients with common variable immunodeficiency, including interstitial lung disease, could be the result of potential biases associated with expert opinion based on a small number of patients.T-cell involvement could be the main underlying cause of this complication so treatment targeting T-cells may possibly be an effective therapeutic option."

Journal • Interstitial Lung Disease • Primary Immunodeficiency • Pulmonary Disease • Respiratory Diseases

UNEXPECTED OUTCOMES OF TREATMENT: AZATHIOPRINE-INDUCED HYPERSENSITIVITY SYNDROME WITH MULTIORGAN DYSFUNCTION IN THE TREATMENT OF MUCOUS MEMBRANE PEMPHIGOID (CHEST 2025) - No abstract available

Immunology

EFFECT OF AZATHIOPRINE AND MYCOPHENOLATE MOFETIL ON LUNG FUNCTION DECLINE IN PATIENTS WITH HYPERSENSITIVITY PNEUMONITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS (CHEST 2025) - No abstract available

Retrospective data • Review • Immunology • Inflammation • Pneumonia • Pulmonary Disease

Spectrum of kidney disease in pediatric sarcoidosis. (PubMed, Pediatr Nephrol) - "Kidney involvement in pediatric sarcoidosis manifests in diverse forms, ranging from isolated biochemical abnormalities to severe AKI. While prompt immunosuppression might preserve kidney function, patients require close monitoring for relapses, and progression to CKD."

Journal • Acute Kidney Injury • Endocrine Disorders • Immunology • Metabolic Disorders • Nephrology • Oncology • Pediatrics • Renal Disease • Sarcoidosis

Cerebrovascular accidents - Unexpected complication of systemic sclerosis: A scarce case report. (PubMed, Medicine (Baltimore)) - "This case highlights a patient with SS who presented with macrovascular stenosis. This unusual presentation underscores the importance of vigilance for macrovascular involvement in SS patients presenting with neurological symptoms."

Journal • Cardiovascular • Fibrosis • Hypertension • Immunology • Ischemic stroke • Rheumatology • Scleroderma • Sjogren's Syndrome • Systemic Sclerosis • Vasculitis

A Case of Hepatosplenic Gamma Delta T Cell Lymphoma With Concomitant Bone Marrow Aplasia Following Azathioprine Therapy, Treatment Course and Review of the Literature. (PubMed, Cancer Rep (Hoboken)) - "To our knowledge, this is the first reported case of HSTCL presenting concurrently with aplastic anemia in the context of prior azathioprine exposure. The underlying pathophysiology is likely multifactorial, involving both immune-mediated suppression and drug-induced toxicity. Clinicians should maintain a high index of suspicion for lymphoma in patients developing unexplained pancytopenia while on azathioprine therapy."

Journal • Review • Aplastic Anemia • Hematological Disorders • Hematological Malignancies • Hepatosplenic T-cell Lymphoma • Immunology • Lymphoma • Oncology • Peripheral T-cell Lymphoma • T Cell Non-Hodgkin Lymphoma • Transplantation

Reduced Intensity Transplantation for Severe Sickle Cell Disease (clinicaltrials.gov) - P2 | N=40 | Suspended | Sponsor: St. Jude Children's Research Hospital | Trial completion date: Aug 2027 ➔ Aug 2029

Trial completion date • Genetic Disorders • Hematological Disorders • Sickle Cell Disease • Transplantation

Esophageal Carcinoma Management Following Liver Transplant (ACG 2025) - "100% had reduction in calcineurin (7/7), 33% in prednisone (1/3), 66% in mycophenolate mofetil (2/3), 0% in everolimus (0/2), and 100% in azathioprine (1/1)...5 were treated with chemoradiation of carboplatin-paclitaxel (2), FOLFOX (2), docetaxel-cisplatin and fluorouracil (1)... Eight patients were diagnosed with esophageal carcinoma following liver transplantation. Average age 66 years, 25% female; 3 were managed surgically and 5 managed medically. Reduction in immunosuppression occurred in 75% of patients."

Anorexia • Barrett Esophagus • Esophageal Cancer • Gastrointestinal Disorder • Graft versus Host Disease • Hepatitis C • Hepatocellular Cancer • Hepatology • Immunology • Infectious Disease • Metabolic Dysfunction-Associated Steatohepatitis • Mucositis • Nephrology • Oncology • Solid Tumor • Squamous Cell Carcinoma • Transplant Rejection • Transplantation

Vedolizumab for Ulcerative Colitis After Treatment of Isolated Rectal Diffuse Large B-Cell Lymphoma (ACG 2025) - "We present a rare case of a patient with Ulcerative Colitis (UC) presenting with refractory symptoms, found to have primary rectal DLBCL.Case Description/ This is a 50-year-old male with UC who presented to his gastroenterologist with ongoing bloody diarrhea despite an escalating regimen including adalimumab, azathioprine, and prednisone...He was treated with R-CHOP (combination chemotherapy including rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) which led to remission of both his DLBCL and UC...This case exemplifies the rare possibility of primary rectal DLBCL in an IBD patient on immunomodulator therapy and the importance of endoscopy to evaluate persistent symptoms despite standard therapy. Furthermore, this case supports other literature suggesting the safety of biologic therapy following successful GI lymphoma treatment."

B Cell Lymphoma • Colorectal Cancer • Diffuse Large B Cell Lymphoma • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Inflammatory Bowel Disease • Lymphoma • Marginal Zone Lymphoma • Non-Hodgkin’s Lymphoma • Solid Tumor • Ulcerative Colitis

Challenges in Managing the Ocular Complications of Stevens-Johnson Syndrome in Patients with Co-Existent Auto-Immune Disease. (PubMed, Semin Ophthalmol) - "They were managed with systemic IMT, including corticosteroids, mycophenolate mofetil (MMF), azathioprine, intravenous immunoglobulin (IVIG), cyclophosphamide, and rituximab. Rituximab and MMF may provide long-term disease control, but discontinuation of IMT should be approached cautiously to prevent recurrence. Further research is needed to optimize treatment protocols and determine the ideal duration of systemic therapy in chronic ocular SJS."

Journal • Immunology • Inflammation • Ocular Inflammation • Rheumatology • Steven-Johnson Syndrome

Mesenteric Panniculitis, Tamoxifen, and Severe Necrotizing Pancreatitis (ACG 2025) - "Following a course of prednisone prescribed by GI, the patient was referred to hematology to rule out non-Hodgkin lymphoma and started on tamoxifen for persistent abdominal pain...Standard treatments involve steroids, tamoxifen and immunosuppressants such as azathioprine, rituximab, cyclophosphamide, infliximab, and methotrexate...High index of suspicion should be maintained for patients on Tamoxifen therapy regardless of duration of use for prompt recognition and management. Figure: Mesenteric PanniculitisFigure: Walled off pancreatic necrosis"

Breast Cancer • Dyslipidemia • Estrogen Receptor Positive Breast Cancer • Fibrosis • Hematological Malignancies • Hormone Receptor Breast Cancer • Hypertriglyceridemia • Immunology • Lipodystrophy • Lymphoma • Metabolic Disorders • Non-Hodgkin’s Lymphoma • Obesity • Pancreatitis • Solid Tumor

Successful Use of Rituximab in Refractory Autoimmune Hepatitis: A Case Report (ACG 2025) - "First-line therapy typically involves corticosteroids in combination with azathioprine, which induces remission in most patients...The patient was initiated on high dose corticosteroids with an initial favorable response and was started on cyclophosphamide for vasculitis management per Rheumatology recommendations...However, despite these encouraging findings, Rituximab has not yet received FDA approval for the treatment of AIH. Additional studies are necessary to further evaluate its efficacy and safety profile in this patient population and to support its integration into standard treatment protocols.Figure: Liver biopsy: Portal based plasma cell rich moderate chronic inflammation with interface hepatitis, moderate lobular inflammation , acidophil bodies and bridging fibrosis ( H&E stain; 200X magnification) Figure: Liver biopsy displaying fibrosis (Masson trichrome stain, 100X magnification)"

Case report • Clinical • ANCA Vasculitis • Autoimmune Hepatitis • Fibrosis • Hepatology • Immunology • Inflammation • Rheumatology • Vasculitis • CD20

NSAID overuse leading to cardiac aneurysm: Unveiling a missed diagnosis of Behçet's disease: A case report. (PubMed, Medicine (Baltimore)) - "This case underscores the life-threatening consequences of undiagnosed BD and highlights how NSAID overuse can obscure early inflammatory symptoms, delay immunosuppressive therapy, and lead to severe cardiac complications. Early recognition, cautious NSAID use, and a multidisciplinary approach are essential in managing BD-related vascular disease."

Journal • Cardiovascular • Hematological Disorders • Pain • Rare Diseases • Thrombosis • Vasculitis

Prevalence, incidence, and risk factors for herpes zoster in systemic lupus erythematosus: a systematic review and meta-analysis. (PubMed, Front Immunol) - "Glucocorticoids use (RRs=2.83, 95%CI 2.10-3.81), cyclophosphamide use (RRs=2.52, 95%CI 1.60-3.98), mycophenolate mofetil use (RRs=3.00, 95%CI 1.07-8.40), azathioprine use (RRs=1.40, 95%CI 1.18-1.67), anifrolumab use (RRs=2.59, 95%CI 1.52-4.41), having lymphopenia (RRs=2.31, 95%CI 1.54-3.46), and the presence of comorbid conditions such as renal involvement (RRs= 1.80, 95%CI 1.34-2.42) were identified to increase the risk of HZ in SLE patients. Concurrently, physicians could be better equipped to choose patients who would most likely gain from the HZ vaccine. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024331310, identifier CRD42024331310."

Journal • Retrospective data • Review • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus • Varicella Zoster

Advances in mechanistic investigation and treatment of steroid-refractory ICI-induced liver injury. (PubMed, Clin Exp Med) - "Recent advancements in therapeutic research have identified promising second-line treatments, including immunosuppressants (tacrolimus, cyclosporine A, mycophenolate mofetil, and azathioprine), monoclonal antibodies (infliximab and tocilizumab), anti-thymocyte globulin, intravenous immunoglobulin, ursodeoxycholic acid for cholestatic cases, and blood purification techniques. Furthermore, we discuss the development of novel therapies informed by evolving insights into the condition's pathogenesis and the feasibility of reintroducing ICIs after ICI-DILI resolution. These advancements mark significant progress in optimizing patient outcomes and advancing the mechanistic understanding of ICI-DILI."

IO biomarker • Journal • Review • Hepatology • Liver Failure • Oncology • ABCB1 • PD-L1 • PD-L2

Eosinophilic Granulomatosis with Poly-Angiitis (EGPA) : A Respiratory perspective (MTS 2025) - "Optimum treatment includes early Corticosteroid treatment , in combination with Rituximab or Cyclophosphamide, as remission induction therapy for EGPA, particularly for life or organ threatening disease. Novel clinical studies of Mepolizumab or Benralizumab as early anti-Interleukin-5/IL-5 Receptor antagonist eosinophil depleting therapy in EGPA are discussed, complementing conventional immunosuppression for remission induction in non-life threatening EGPA, and as early remission maintenance regimens, to facilitate corticosteroid weaning, to reduce steroid related co-morbidity and immunosuppression burden, and ensure long term maintenance remission. Rituximab, Methotrexate, mycophenolate or Azathioprine may be considered as alternative options when anti-IL-5/ IL-5R not available, or as adjunctive maintenance therapies depending on disease phenotype."

Allergic Bronchopulmonary Aspergillosis • ANCA Vasculitis • Asthma • Eosinophilia • Hematological Disorders • Immunology • Inflammation • Langerhans Cell Histiocytosis • Otorhinolaryngology • Pneumonia • Respiratory Diseases • Rheumatology • Vasculitis • IL5

Immunosuppressant Management in Rheumatology Patients Undergoing Elective Total Shoulder Arthroplasty (clinicaltrials.gov) - P2 | N=80 | Not yet recruiting | Sponsor: NYU Langone Health

New P2 trial • Orthopedics • Rheumatology

Updates on immunosuppressant safety and malignancy risk in patients with multiple sclerosis. (PubMed, Expert Opin Drug Saf) - "This review discusses immunosuppressants in MS, from older cytotoxic agents (azathioprine, cyclophosphamide, mitoxantrone) to newer therapies (cladribine, alemtuzumab, and anti-CD20 monoclonal antibodies). Ongoing research, including predictive biomarkers and post-marketing surveillance, will refine patient selection and mitigate adverse events. With judicious use and robust safety protocols, clinicians can achieve durable disease control while minimizing long-term toxicities."

Journal • Review • CNS Disorders • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Multiple Sclerosis • Oncology • Urothelial Cancer

Mycophenolate mofetil plus methotrexate versus cyclophosphamide with sequential azathioprine for treatment of Takayasu arteritis. (PubMed, Ann Rheum Dis) - "Treatment of active TAK with MMF+MTX has more favourable efficacy compared to CYC/AZA. These findings provide evidence to use the combination of MTX and MMF, 2 generally well-tolerated and inexpensive therapies, to treat TAK."

Journal • Febrile Neutropenia • Hematological Disorders • Neutropenia • Vasculitis

Real-world outcomes of rituximab- and cyclophosphamide-based induction therapy regimens alone and in combination over 24 months in ANCA-associated vasculitis. (PubMed, Clin Exp Rheumatol) - "RTX alone was similarly effective to RTX/CYC combination and CYC-AZA therapy in AAV patients, including those with severe renal involvement."

Journal • Real-world evidence • ANCA Vasculitis • Nephrology • Rare Diseases • Renal Disease • Vasculitis

Reclassification of Seronegative Rheumatoid Arthritis as Anti-PL-12 Antisynthetase Syndrome with Interstitial Lung Disease and Joint Involvement-Case Report. (PubMed, Reports (MDPI)) - "Treatment with corticosteroids and cyclophosphamide induced clinical and functional respiratory improvement, while azathioprine was initiated for maintenance. Importantly, it demonstrates that in patients with pre-existing rheumatologic diagnoses, the emergence of atypical pulmonary manifestations warrants repeat serologic evaluation to assess ASyS and other autoimmune conditions. Early diagnosis and immunosuppressive treatment are essential to optimize outcomes."

Journal • Cardiovascular • Cough • Immunology • Infectious Disease • Inflammatory Arthritis • Interstitial Lung Disease • Myositis • Pneumonia • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Sjogren's Syndrome

Plot Twist: Neuroendocrine Tumor in a Patient With Ileal Pouch-Anal Anastomosis (ACG 2025) - "We present a case of mixed poorly differentiated adenocarcinoma and NET arising in the ileoanal pouch of a patient with a history of ileal pouch-anal anastomosis (IPAA).Case Description/ A 36-year-old male with a history of 2-stage IPAA for medically refractory ulcerative colitis complicated by Crohn's-like disease of the pouch (on ustekinumab 90 mg SQ every 4 weeks) presented with abdominal pain...He transitioned to combination therapy with infliximab and azathioprine...Pathologic stage I (pT1, pN0, cM0), histologic grade 3, and residual tumor (R) R1 (microscopic).Figure: Figure 2. PET-CT with a small FDG-avid abdominal soft tissue nodule subjacent to the right anterior abdominal wall (A) and prominent node in central mesentery (B) suspicious for metastasis."

Clinical • Crohn's disease • Endocrine Cancer • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Neuroendocrine Carcinoma • Neuroendocrine Tumor • Obesity • Oncology • Solid Tumor • Ulcerative Colitis • SYP

A Rare Case of CMV Hepatitis Occurring in a Young Patient With Autoimmune Polyglandular Syndrome and Pediatric-Onset Autoimmune Hepatitis (ACG 2025) - "Although cases of CMV hepatitis have been reported, there is only 1 case report of CMV hepatitis occurring in a patient with autoimmune hepatitis (AIH) (on azathioprine [AZA] and steroids), along with Sweet Syndrome...AZA and steroids were held and she was treated with valganciclovir...She remains on maribavir for now, along with low dose prednisone. This is a rare case of acute CMV hepatitis in an immunocompromised host with longstanding AIH, on maintenance AZA and steroids...An early diagnosis is key to instituting effective treatment and achieving a good outcome. The therapeutic challenge will be navigating re-institution of her immunosuppression regimen for AIH, while at the same time monitoring closely for persistence or reactivation of her CMV hepatitis after her anti-viral therapy is completed."

Clinical • Autoimmune Hepatitis • Cytomegalovirus Infection • Dermatology • Fatigue • Fibrosis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Ocular Infections • Pediatrics • Solid Organ Transplantation