Question

A 29-year-old man with Crohn's disease, maintained on azathioprine, presents with a 3-day history of fever, sore throat, and malaise. His blood tests show: Hb 125 g/L, WBC 1.8 x 10^9/L (Neutrophils 0.6 x 10^9/L), Platelets 150 x 10^9/L. What is the most important immediate action?

Accepted Answer

Temporarily stop azathioprine and arrange urgent hospital assessment

Answer

Administer oral co-amoxiclav and review in 24 hours

Answer

Advise paracetamol and throat lozenges

Answer

Check thiopurine methyltransferase (TPMT) activity level

Answer

Increase the dose of azathioprine

Practice question

A 29-year-old man with Crohn's disease, maintained on azathioprine, presents with a 3-day history of fever, sore throat, and malaise. His blood tests show: Hb 125 g/L, WBC 1.8 x 10^9/L (Neutrophils 0.6 x 10^9/L), Platelets 150 x 10^9/L. What is the most important immediate action?