title: A study of the utility of azathioprine metabolite testing in myasthenia gravis.
abstract: Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterised by fatigable voluntary skeletal muscle weakness. The underlying pathogenesis is complex involving adaptive autoimmune responses. Azathioprine remains a first line broad acting immunosuppressant for MG. Due to varied clinical responses to azathioprine we aimed to investigate the relationship between azathioprine metabolites and symptom control. Mild correlations between Quantitative Myasthenia Gravis Score (QMG) vs. 6-thioguanine nucleotides (R=-0.317 p=0.186) and QMG vs. lymphocyte count (R=0.402 p=0.08) were found. Azathioprine metabolite measurement should be considered in MG patients with; pancytopenia, deranged liver function or recurrent infections.
authors.affiliation: Department of Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: will.rae@nhs.net.
authors.forename: William
authors.initials: W
authors.lastname: Rae
authors.affiliation: Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Georgina
authors.initials: G
authors.lastname: Burke
authors.affiliation: Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001379:Azathioprine / Q000378:metabolism*; D002452:Cell Count; D015331:Cohort Studies; D005260:Female; D006150:Guanine Nucleotides / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000378:metabolism*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000276:immunology*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013873:Thionucleotides / Q000378:metabolism
chemical_list: D006150:Guanine Nucleotides; D007166:Immunosuppressive Agents; D013873:Thionucleotides; C003964:6-thioguanylic acid; D001379:Azathioprine
keywords: Azathioprine; Lymphocytes; Myasthenia gravis; Thiopurine metabolites