<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 47-year-old female with a history of poorly controlled type I diabetes mellitus and end-stage renal disease undergoes an allogeneic renal transplant. Her immediate post-operative period is unremarkable and she is discharged from the hospital on post-operative day 4. Her past medical history is also notable for major depressive disorder, obesity, and gout. She takes sertraline, allopurinol, and insulin. She does not smoke or drink alcohol. To decrease the risk of transplant rejection, her nephrologist adds a medication known to serve as a precursor to 6-mercaptopurine. Following initiation of this medication, which of the following toxicities should this patient be monitored for?? A: Hyperlipidemia, B: Osteoporosis, C: Hirsutism, D: Cytokine storm, E: Pancytopenia,  <response>: This is a question about potential side effects of a medication given to prevent transplant rejection in a kidney transplant recipient. The medication is a precursor to 6-mercaptopurine, which is an immunosuppressive medication. The patient has multiple comorbidities including diabetes, depression, obesity and gout. The question asks which toxicity the patient should be monitored for after starting this new medication. Since it is an immunosuppressive medication, we need to consider side effects related to lowered immune function. Hyperlipidemia, osteoporosis and hirsutism are not known side effects. Cytokine storm is a severe immune reaction, which is less likely with immunosuppression. Pancytopenia refers to low levels of all blood cell types and is a known side effect of immunosuppressive medications that suppress the bone marrow.E: Pancytopenia 