6-Thioguanine for Crohn's disease during pregnancy: thiopurine metabolite measurements in both mother and child.
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.
de Boer
Nanne K H
NK
Department of Gastroenterology and Hepatology, PO Box 7057, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands. KHN.deBoer@vumc.nl
Van Elburg
Ruurd M
RM
Wilhelm
Abraham J
AJ
Remmink
Adriana J
AJ
Van Vugt
John M G
JM
Mulder
Chris J J
CJ
Van Bodegraven
Adriaan A
AA
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
D013866:Thioguanine