The importance of the application of thiopurine methyltransferasefor the initiation of azathioprine. Our experience
Keywords:
azathioprine, thiopurin methyltransferase, mielosuppressionAbstract
The azathioprine (AZA) is a immunosuppressive drug used in many dermatological diseases. One of the enzymes responsible of metabolizing the drug into its inactive form is the thiopurin methyltransferase (TPMT). The deficiency of this enzyme turns into serious side effects, being the most serious the mielosuppression. This deficit can be diagnosed through a genetic study of the enzyme. We present a patient who had an haematological impact by AZA and after the clinical complication we found the enzymatic deficit. For this reason, we want to assess the importance of its dosage prior to the incorporation of full doses of AZA.References
I. Coulthard S, Hogarth L. Thethiopurines: an update. Invest New Drugs 2005;23:523-532.
II. Coraminas H, Domènech M, González Juan D, González Suárez B, et ál. Aplasia medular tras administración de azatioprina: papel del polimorfismo genético de la tiopurinametiltransferasa. Med Clin (Barc) 2000;115:299-301.
III. Kerstens PJ, Stolk JN, De Abreu RA, Lambooy LH, et ál. Azathioprine related bone marrow toxicity and low activities of purine enzymes in patients with rheumatoid arthritis. Arthritis Rheum 1995;38:142-145.
IV. Bakker JA, Drent M, Bierau J. Relevance of pharmacogenetic aspects of mercaptopurine metabolism in the treatment of interstitial lung disease. Curr Opin Pulm Med 2007;13:458-463.
V. Kurzawski M, Dziewanowski K, Lener A, Drozdzik M. TPMT but not ITPA gene polymorphism influences the risk of azathioprine intolerance in renal transplant recipients. Eur J Clin Pharmacol 2009;65:533-540.
VI. Sanderson J, Ansari A, Marinaki T, Duley J. Thiopurine methyltransferase: should it be measured before commencing thiopurine drug therapy. Ann Clin Biochem 2004;41:294-302.
VII. Sahasranaman S, Howard D, Roy S. Clinical pharmacology and pharmacogenetics of thiopurines. Eur J Clinic Pharmacol 2008;64:753-767.
VIII. Cabré E. Indicaciones de la azatioprina (o 6-mercaptopurina) en la enfermedad inflamatoria intestinal. Gastroenterol Hepatol 2002;25:319-326.
IX. Anstey AV, Wakelin S, Reynolds NJ. Guidelines for prescribing azathioprine in dermatology. Br J Dermatol 2004;151:1123-1132.
X. Jeurissen MEC, Boerbooms TM, Van De Putte LBA. Pancytopenia related to azathioprine in rheumatoid arthritis. Ann Rheum Dis 1988;47:503-505.
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