Which statement accurately describes azathioprine?

• A. It is an immunosuppressant drug that can cause bone marrow suppression and increases infection risk.
• B. It improves wound healing.
• C. It causes increased immune function.
• D. It has no effect on infection risk.

Answer: (A)

Azathioprine is an immunosuppressant that works by inhibiting purine synthesis, which slows the growth of rapidly dividing cells like those in the bone marrow. Because the bone marrow produces white blood cells that defend against infection, its suppression can lead to leukopenia and other cytopenias. With fewer immune cells, the risk of infections rises, making bone marrow suppression a key adverse effect of this drug. This is why the statement describing it as immunosuppressive with potential bone marrow suppression and increased infection risk is correct.

In practice, this means monitoring a complete blood count and watching for signs of infection (fever, sore throat, fatigue), as well as checking liver enzymes and other potential toxicities. Live vaccines should be avoided during therapy, and be mindful of drug interactions (for example, allopurinol can increase azathioprine toxicity). Wound healing can be impaired with immunosuppressants, so statements claiming it improves healing or has no effect on infection risk aren’t accurate.