Azathioprine Therapy in a Pediatric TPMT-Deficient Patient-Still an Option

Ther Drug Monit. 2017 Feb;39(1):1-4. doi: 10.1097/FTD.0000000000000366.

Abstract

We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase-deficient IBD patients.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Azathioprine / administration & dosage
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Hypersensitivity / complications*
  • Drug Hypersensitivity / diagnosis
  • Drug Monitoring / methods
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Inflammatory Bowel Diseases / drug therapy*
  • Male
  • Purine-Pyrimidine Metabolism, Inborn Errors / complications*
  • Purine-Pyrimidine Metabolism, Inborn Errors / diagnosis
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Azathioprine

Supplementary concepts

  • Thiopurine S methyltranferase deficiency