title: 6-Thioguanine for Crohn's disease during pregnancy: thiopurine metabolite measurements in both mother and child.
abstract: 6-Thioguanine is used as an escape thiopurine for treating inflammatory bowel disease patients intolerant or refractory to azathioprine, 6-mercaptopurine or methotrexate. Case reports show conflicting data on the use of 6-thioguanine throughout pregnancy. The administration of the standard thiopurines is believed to be relatively safe. We describe two patients with Crohn's disease treated with low-dose 6-thioguanine during all trimesters of their pregnancies. The pregnancies resulted in two healthy infants: without congenital abnormalities, laboratory signs of myelosuppression or hepatocellular injury. Thiopurine metabolites were measured in mother and infant. Significantly lower levels of 6-thioguaninenucleotides were found in the erythrocytes of the infant compared to the mother (ratio 1:12). Further studies are needed to determine the clinical importance of thiopurine metabolite measurements during pregnancy in mother and child.
authors.affiliation: Department of Gastroenterology and Hepatology, PO Box 7057, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands. KHN.deBoer@vumc.nl
authors.forename: Nanne K H
authors.initials: NK
authors.lastname: de Boer
authors.forename: Ruurd M
authors.initials: RM
authors.lastname: Van Elburg
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Wilhelm
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: Remmink
authors.forename: John M G
authors.initials: JM
authors.lastname: Van Vugt
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Van Bodegraven
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D018570:Risk Assessment; D012720:Severity of Illness Index; D013866:Thioguanine / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D013866:Thioguanine