[en] Thiopurine S-methyltransferase (TPMT) deficient patients develop life threatening haematoxicity (for example, pancytopenia) when treated with a standard dose of azathioprine (AZA) and 6-mercaptopurine (6-MP) due to excessive accumulation of cytotoxic metabolites. At present, it is generally recommended that these patients should not receive AZA or 6-MP treatment for inflammatory bowel disease. We report for the first time that Crohn's disease patients with TPMT deficiency can be successfully treated with AZA. We illustrate this with three cases where treatment has been successful and toxicity has been avoided by carefully titrating the drug dose. Thus very low TPMT activity demands pharmacogenetically guided dosing.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Kaskas, B. A.
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Hindorf, U.
Schaeffeler, E.
Deflandre, Jean-Luc ; Centre Hospitalier Universitaire de Liège - CHU > HOPITAL DE JOUR
Graepler, F.
Schmiegelow, K.
Gregor, M.
Zanger, U. M.
Eichelbaum, M.
Schwab, M.
Language :
English
Title :
Safe treatment of thiopurine S-methyltransferase deficient Crohn's disease patients with azathioprine
Publication date :
January 2003
Journal title :
Gut
ISSN :
0017-5749
eISSN :
1468-3288
Publisher :
British Med Journal Publ Group, London, United Kingdom
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