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Mercaptopurine-induced fever in a patient with Crohn's disease

E L Rehr1, K A Swanson, J A Kern

  • 1Department of Emergency Medicine, Monmouth Medical Center, Long Branch, NJ 07740.

The Annals of Pharmacotherapy
|July 1, 1992
PubMed
Abstract

Insights

Mercaptopurine (6-MP) can cause drug-induced fever in Crohn's disease patients. This uncommon adverse effect requires careful diagnosis of exclusion, as symptoms mimic infection.

Area of Science:

  • Gastroenterology
  • Clinical Pharmacology
  • Immunology

Background:

  • Inflammatory bowel disease (IBD) management often involves immunosuppressive agents.
  • Mercaptopurine (6-MP) is a thiopurine analog used in IBD treatment.
  • Adverse drug reactions can complicate IBD therapy.

Observation:

  • A Crohn's disease patient developed fever and chills during 6-MP treatment.
  • Symptoms persisted despite antimicrobial therapy, suggesting an alternative cause.
  • Fever and chills recurred upon 6-MP rechallenge, confirming drug-induced fever.

Findings:

  • 6-MP can induce an uncommon allergic-type fever in IBD patients.
  • Diagnosing drug-induced fever requires excluding infectious etiologies.
  • Rechallenge is a key diagnostic step but carries risks.

Implications:

  • Clinicians should consider 6-MP-induced fever in IBD patients presenting with unexplained fever.
  • This highlights the importance of a thorough diagnostic workup for adverse drug reactions.
  • Early recognition and drug withdrawal are crucial for patient management.

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