title: Safe 6-thioguanine therapy of a TPMT deficient Crohn's disease patient by using therapeutic drug monitoring.
abstract: The immunosuppressive thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP), have proven efficacy in steroid-dependant or refractory inflammatory bowel disease (IBD). In case of TPMT deficiency serious myelosuppression may occur. 6-thioguanine (6-TG), has been suggested in case of AZA and 6-MP resistant or intolerant patients. Our case demonstrates that very low dose 6-TG under close clinical surveillance and frequent therapeutic drug monitoring, may be a rescue drug for IBD-patients with low or without functional TPMT activity.
authors.affiliation: Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: W G N
authors.initials: WG
authors.lastname: Mares
authors.forename: D R
authors.initials: DR
authors.lastname: Wong
authors.forename: L P L
authors.initials: LP
authors.lastname: Gilissen
authors.forename: A A M
authors.initials: AA
authors.lastname: Masclee
authors.forename: P M
authors.initials: PM
authors.lastname: Hooymans
authors.forename: L G J B
authors.initials: LG
authors.lastname: Engels