A 50-year-old woman comes to the physician for the evaluation of fatigue over the past 6 months. During this period, the patient has also had a 5 kg (11-lb) weight loss. She has a history of Hashimoto thyroiditis. She does not smoke. She drinks one glass of wine per day. She does not use illicit drugs. Her only medication is levothyroxine. Temperature is 37°C (98.6°F), pulse is 70/min, and blood pressure is 110/70 mm Hg. Abdominal examination shows tenderness in the right upper quadrant with no rebound or guarding. Laboratory studies show a serum alanine aminotransferase level of 190 U/L, serum aspartate aminotransferase level of 250 U/L, and serum total bilirubin level of 0.6 mg/dL. an autoimmune hepatitis diagnosis is done If zathioprine is prescribed for continued management of autoimmune hepatitis. Which of the following should be periodically monitored while the patient is taking this new medication?

Question

Quizplus · Accepted Answer

Eductional Objective: 
Azathioprine is an immunosuppressant that functions via inhibition of purine synthesis by its pharmacologically active 6-thioguanine metabolites. In addition to the desired effect of reduced lymphocyte proliferation, the proliferation of other hematologic cell lines (eg, neutrophils, erythrocytes, platelets) is reduced, leading to a common adverse effect of pancytopenia

A 50-Year-Old Woman Comes to the Physician for the Evaluation