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Azathioprine pancreatitis signal — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsAzathioprine pancreatitis signalGPhC CRA

A 29-year-old man with Crohn's disease started azathioprine 2 weeks ago. He reports severe upper abdominal pain radiating to the back with vomiting. His baseline TPMT was normal, and he also takes mesalazine. He has no diarrhoea today. What is the most appropriate action?

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Correct answer: C — Stop azathioprine and arrange urgent medical assessment

Azathioprine can cause acute pancreatitis, which may present with severe epigastric pain radiating to the back and vomiting. Normal TPMT reduces myelosuppression risk but does not rule out pancreatitis. The medicine should be stopped and urgent assessment arranged. Routine antacid advice would be unsafe.

Reference: BNF Azathioprine; NICE CKS Crohn's disease