MCQ – 88967


You are seeing in follow-up a 46-year-old man who, 6 months ago, presented to the hospital acutely with hemoptysis, diffuse nodular pulmonary infiltrates, and glomerulonephritis. Workup revealed a positive serologic study for antibodies against cytoplasmic ANCA, and he was eventually diagnosed with granulomatosis with polyangiitis. Treatment was initiated with high-dose glucocorticoids and daily cyclophosphamide with excellent clinical response. You are ready today to have the patient transition from induction therapy with cyclophosphamide to maintenance therapy with azathioprine. What blood test should you check before starting azathioprine?

A. ANCA titers




 CYP3A4 genotyping


Thiopurine methyltransferase enzyme activity

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