Crohn's Disease — UKMLA MCQ

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A 35-year-old man with Crohn's disease, currently in remission on azathioprine, attends for routine blood monitoring. Which parameter is most crucial to monitor regularly specifically due to azathioprine therapy?

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Correct answer: A — Full blood count (FBC)

Azathioprine can cause bone marrow suppression, leading to leucopenia, thrombocytopenia, or anaemia. Therefore, regular monitoring of the Full Blood Count (FBC) is essential throughout treatment, typically weekly initially then reducing to every 3 months once stable. LFTs should also be monitored as azathioprine can cause hepatotoxicity, but myelosuppression is often considered the most immediate life-threatening risk requiring frequent FBC checks. U&Es, CRP, and folate are monitored for other reasons related to Crohn's disease or general health but are not the primary specific monitoring requirement for azathioprine toxicity related to bone marrow.

Reference: BNF: Azathioprine