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A patient [ age at reaction onset and sex not stated ] developed haemorrhagic colitis during treatment with azacitidine. The patient had myelodysplastic syndrome (MDS) and was treated with subcutaneous azacitidine [dosage not stated]. At the end of the third cycle of treatment with azacitidine, they developed severe haemorrhagic colitis. The patient's status rapidly deteriorated and they developed colonic perforation. A colostomy was performed. The patient later developed renal failure and, despite dialysis, died.