Peiyun, A sensitive inhibition chemiluminescence method for the determination of
6-mercaptopurine in tablet and biological fluid using the reaction of luminol-Ag(III) complex in alkaline medium, J.
Azathioprine and
6-mercaptopurine for maintenance of remission in ulcerative colitis.
After popular columnist Walter Winchell reported on the near-miraculous results, public demand for
6-mercaptopurine forced the Food and Drug Administration (FDA) to expedite its approval.
(4) With high-risk multisystem disease, as in the case reported, a chemotherapy regimen of vinblastine, prednisone, and
6-mercaptopurine for 12 months per LCH III protocol is indicated.
Sutherland, "Azathioprine or
6-mercaptopurine for induction of remission in Crohn's disease," Cochrane Database of Systematic Review, vol.
The "step-up" approach requires to start treatment with aminosalicylates (salazopirin or mesalazine) and, in case of therapeutic failure, corticotherapy followed by immunosuppressant treatment with azathioprine, cyclosporine,
6-mercaptopurine or methotrexate.
Treatment of gastrointestinal disorders in agammaglobulinemia with intravenous immunoglobulins alone may be ineffective in comparison to combination with immunomodulators such as azathioprine and
6-mercaptopurine, because most gastrointestinal manifestations of agammaglobulinemia appear to be due to defects in T-cell mediated immunity [1].
Moderate ulcerative colitis: (i) Mayo score between 6 and 10 (inclusive), (ii) endoscopic subscore of 2, (iii) failed 2 weeks of oral prednisone 40 Infliximab (Remicade[R]) mg-day (or IV equivalent for at least 1 week) and 3 months of azathioprine or 6- mercaptopurine, or where the use of immunosuppressants is contraindicated, (iv) stabilized with 2 weeks of oral prednisone [greater than or equal to] 40 mg-day (or IV equivalent for at least 1 week) but the prednisone dose cannot be tapered despite 3 months of azathioprine or
6-mercaptopurine, or where the use of immunosuppressants is contraindicated.
A previous study by Uchigata and Hirata [7] in 330 Japanese IAS patients demonstrated that 78% of the patients had spontaneous remission or resolution after avoiding culprit drug exposure, 9% required steroid treatment, 7.3% were treated with alpha-glucosidase inhibitor, 2.4% had severe hypoglycemia and required plasmapheresis, 1.8% underwent pancreatic surgery, and 0.6% were treated with other immunosuppressive drugs such as azathioprine and
6-mercaptopurine. Our patient was successfully treated with dietary management mainly by avoidance of simple carbohydrate.
The patient received 8 cycles of chemotherapy and is currently receiving maintenance chemotherapy with methotrexate and
6-mercaptopurine.
Azathioprine and
6-mercaptopurine can also cause side effects, including allergic reactions, leucopenia, pancreatitis, nausea, and abnormal liver function tests.