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Atypical bone marrow, compatible with azathioprine toxicity.
Bone Marrow
Haematoxylin & Eosin (H&E)
80 years
80-year old female patient with systemic lupus erythematosus and immunosuppressive therapy (azathioprine). Currently, she suffers from leukopenia and hyporegenerative macrocytic hyperchromatic anemia.
Normocellular bone marrow with dysmaturation showing hyperplastic megakaryopoiesis with striking nuclear atypia. In addition, erythropoiesis is dysorganized showing severe macroblastic changes and the myelopoiesis is dysmaturating.
After our diagnosis a thiopurine methyltransferase (TPMT) deficiency was proven
Philippe Brunner, University of Basel
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