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Azathioprine Therapy in a Pediatric TPMT-Deficient Patient-Still an Option
S A W van Moorsel1, N Bevers, M Meurs
1*Department of Clinical Pharmacy and Toxicology, Zuyderland Medical Centre, Sittard-Geleen;†Department of Pediatrics, Zuyderland Medical Centre, Heerlen; and‡Department of Clinical Pharmacy and Toxicology, Zuyderland Medical Centre, Heerlen, the Netherlands.
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.
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