A 60-year-old male was initiated on azathioprine 50 mg/day for airborne contact dermatitis after a thorough laboratory evaluation including hemogram, liver and renal function tests and chest radiography. His blood pressure ranged between 130/80 and 140/100 mm Hg. As the patient had satisfactory response while on azathioprine therapy, the dose was escalated to 100 mg/day after two weeks. The patient started feeling unwell from that day onwards and developed nausea and vomiting.
He had no history of drug allergies in the past. In the following two days, he developed vague abdominal pain, high spiking fever with chills usually in mid-mornings, watery diarrhea and two episodes of hypotension (his blood pressure fell from 140/100 mm Hg to 90/60 mm Hg on two separate occasions on two days in the mid-morning) which were detected when he collapsed in the ward. What could be the probable reason…
