Azathioprine is an immunosuppressant widely used in the management of autoimmune and inflammatory disorders, including dermatological conditions. Despite its clinical usefulness, it is associated with a wide range of adverse effects, the most significant of which is bone marrow suppression. Necrotising gastritis is a rare and life-threatening condition where predisposing factors include immunosuppression. This case report describes a fatal necrotising gastritis following immunosuppression due to azathioprine therapy. The clinical presentation, laboratory investigations, ultrasound scan evidence, and the autopsy findings were supportive of gastrointestinal sepsis. This fatal outcome highlights the importance of haematological monitoring, clinical vigilance, and prompt recognition of early signs of drug toxicity or infection.
Jayasinghe et al. (Mon,) studied this question.