Blood count results

Hello,

I have just had a regular blood test after 9 months on azathioprine. I have contacted my doctor as the results show that a number of the levels (Hemoglobin, RDW, Hermatocrit etc.) are way off what it says is the normal range.

I was just wondering if this is always to be expected with imuran or if it should be a cause for concern? Last time I had a blood test (3 months ago) my doctor said it was normal for some of the levels to be off as this suggests the imuran is acting. However, from comparing the two it looks like several of the levels have gone even further from the normal range since then.

Anyone have any info about this? Should I be concerned or is it pretty normal?

Thanks!

So I have heard back from my doctor and he says the blood test results suggest bone marrow toxicity and that I will likely have to come off azathioprine. I am meeting him on Wednesday to discuss options.

Has anyone else been through this, apparently it's quite a rare complication of azathioprine. I am a bit depressed about it as I have had great results from this medication in terms of colitis symptoms. I'm hoping it may be possible to continue with it at a reduced dose.

If our blood numbers become concerning, then either we reduce dosage or discontinue. It depends how bad those numbers are. Any dosage reduction or discontinuation will take a minimum of 6-weeks to show a difference within our blood test results. Often it can take 8-weeks for our numbers to turn in the right direction.

Yes, I had this happen once with 6MP a number of years ago. My neutrophils were dropping month-over-month further below the normal range. My gasteroenteroligist called it neutropenia (chronic, low neutrophils) and had me cut my dosage from 75mgs a day to 50mgs a day, and about 8 weeks later my numbers returned to normal. I am still on 6mp today, and am even back to 75mgs a day without issue today.

Thanks. Good to know your options and discuss them with your doctor.

Footnote #1: The 6mp dosages are roughly 1/2 of what the azathioprine/Imuran dosages are, so, my 75mgs a day of 6mp is roughly equivalent to your 150mgs of azathioprine/Imuran.

Footnote #2: 6mp/Imuran/azathioprine are weight-based dosages, so if you and I have significantly different weights then that can affect our dosage. I'm about 160 pounds or 72 kilograms. It'd have to be significant (i.e., you weighed 100 pounds or 200+ pounds, or something).