Rapid periapical bone destruction during endodontic treatment of a patient with rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disease with an unknown etiology. Azathioprine is an immunosuppressive drug that is used to treat rheumatoid arthritis. This case report describes the rapid periapical bone destruction that occurred during the endodontic treatment of a rheumatoid arthritis patient taking azathioprine and a corticosteroid. The cause of the rapid destruction is unclear. However, severe side effects can occur after administering azathioprine to rheumatoid arthritis patients. Therefore, dentists should check the patient's medical state thoroughly in order to prevent side effects when performing endodontic treatment.