Volume 25, Issue 114, August 2021

An undue guest of thrombotic thrombocytopenic purpura with acute myeloid leukemia in an elderly patient with Crohn’s disease

Khairul Najmi Muhammad Nawawi¹, Sopian Abdul Wahab¹, Wong Zhiqin¹, Nor Rafeah Tumian², Raja Affendi Raja Ali^1♦

¹Gastroenterology Unit, Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
²Hematology Unit, Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia

^♦Corresponding author
Gastroenterology Unit, Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia

ABSTRACT

Thrombotic thrombocytopenic purpura and acute myeloid leukemia are rarely associated with Crohn’s disease. Early recognition of these conditions with timely referral to hematologist is paramount. Acute myeloid leukemia should be suspected despite the absence of blast cells from peripheral blood film. Although is rare, thiopurines like azathioprine have been associated with increased risk of acute myeloid leukemia. Therefore, patients should be given informed consent of this risk prior to initiation of thiopurines therapy.

Keywords: acute myeloid leukemia, azathioprine, Crohn’s disease, thiopurines, thrombotic thrombocytopenic purpura

Medical Science, 2021, 25(114), 2025-2029

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