<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492026000100152</article-id>
<article-id pub-id-type="doi">10.18004/anales/2026.e59012652</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Efluvio anágeno inducido por azatioprina: reporte de efecto adverso infrecuente]]></article-title>
<article-title xml:lang="en"><![CDATA[Azathioprine-Induced Anagen Effluvium: A Report of a Rare Adverse Effect]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Centurión Villalba]]></surname>
<given-names><![CDATA[Aramí María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Contreras]]></surname>
<given-names><![CDATA[Claudia Romina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Riveros Rivarola]]></surname>
<given-names><![CDATA[Rosalba Elizabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte Fariña]]></surname>
<given-names><![CDATA[Claudia Nataly]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldama Caballero]]></surname>
<given-names><![CDATA[Arnaldo Benjamín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas, Cátedra y Servicio de Dermatología]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>59</volume>
<numero>1</numero>
<fpage>152</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492026000100152&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492026000100152&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492026000100152&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La azatioprina es un fármaco inmunosupresor ampliamente utilizado en patologías dermatológicas autoinmunes. Es un análogo de las purinas y actúa inhibiendo una enzima que interviene en la síntesis del ADN, afectando la proliferación celular. Entre los efectos adversos por este mecanismo de acción se describe la supresión medular, alteraciones hepáticas y a nivel dermatológico úlceras bucales y pocos casos publicados de efluvio anágeno. Algunas de estas manifestaciones podrían estar relacionados a niveles bajos de la enzima tiopurina metiltransferasa, encargada de inactivar metabolitos derivados de las purinas. El efluvio anágeno suele presentarse en las primeras semanas tras el inicio de la azatioprina y suele ser reversible con la suspensión del fármaco. Se presenta el caso de una paciente femenina de 36 años con diagnóstico de síndrome de ojo seco, en tratamiento con hidroxicloroquina e inicio de azatioprina 50mg/día, con lo cual presentó agranulocitosis con requerimiento de internación, y que desarrolló posteriormente caída de pelo difusa luego de 2 semanas del inicio del inmunosupresor, sin otros factores predisponentes asociados, con patrón sugerente de efluvio anágeno, con buena respuesta clínica tras la suspensión del inmunosupresor y tratamiento con minoxidil tópico y oral, con repilación al mes de implementada la terapéutica, con interés particular por los escasos reportes publicados en la literatura de efluvio anágeno asociado al uso de azatioprina y la rápida y excelente respuesta a la suspensión de la azatioprina.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Azathioprine is an immunosuppressive drug widely used in autoimmune dermatological diseases. It is a purine analog that acts by inhibiting an enzyme involved in DNA synthesis, thereby affecting cellular proliferation. Adverse effects related to this mechanism of action include bone marrow suppression, hepatic abnormalities, oral ulcers, and, at the dermatological level, a few published cases of anagen effluvium. Some of these manifestations may be associated with low levels of the enzyme thiopurine methyltransferase, which is responsible for inactivating purine-derived metabolites. Anagen effluvium usually develops during the first weeks after the initiation of azathioprine therapy and is generally reversible following drug discontinuation. We report the case of a 36-year-old female patient with a diagnosis of dry eye syndrome, receiving hydroxychloroquine therapy and subsequently started on azathioprine 50 mg/day. She developed agranulocytosis requiring hospitalization and subsequently experienced diffuse hair loss two weeks after initiating the immunosuppressive therapy, without other associated predisposing factors, with a pattern suggestive of anagen effluvium. The patient showed a favorable clinical response after discontinuation of azathioprine and treatment with topical and oral minoxidil, with hair regrowth observed one month after the initiation of therapy. This case is of particular interest because of the limited number of published reports describing anagen effluvium associated with azathioprine use and the rapid and excellent response following withdrawal of the drug.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[azatioprina]]></kwd>
<kwd lng="es"><![CDATA[enfermedades del pelo]]></kwd>
<kwd lng="es"><![CDATA[alopecia]]></kwd>
<kwd lng="en"><![CDATA[azathioprine]]></kwd>
<kwd lng="en"><![CDATA[hair diseases]]></kwd>
<kwd lng="en"><![CDATA[alopecia]]></kwd>
</kwd-group>
</article-meta>
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