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Azathioprine Pancreatitis — SCE Rheumatology MCQ

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HardRheumatology PharmacologyAzathioprine PancreatitisSCE Rheumatology

Two weeks after starting azathioprine, a patient develops imaging-confirmed acute pancreatitis. Gallstones, alcohol, hypertriglyceridaemia and active lupus are not supported. What is the safest drug plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Stop azathioprine and do not rechallenge because recurrence is likely

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

A is correct. The timing and exclusion of common alternatives support idiosyncratic azathioprine pancreatitis. The drug is stopped and rechallenge avoided because recurrence is frequent and may be severe. B proposes the hazardous rechallenge. C treats dose independence as reassurance. D does not prevent recurrence. E uses a closely related thiopurine before returning to the culprit.

Reference: Azathioprine 50 mg tablets — UK SmPC: https://www.medicines.org.uk/emc/product/11142/smpc