Massive airway edema after azathioprine.

Abstract

AZATHIOPRINE is an antimetabolite widely used to suppress the immune system in recipients of organ transplants, as well as in patients with primary autoimmune disorders. Over the past 30 yr, it has proved to be an effective agent. However, multiple side effects have been reported, ranging in severity from fever and rash to cardiovascular collapse. 1,2 We report an acute idiosyncratic reaction to azathioprine in a patient undergoing kidney transplantation, characterized by life-threatening upper airway edema and circulatory collapse, both of which were elicited again after rechallenge.