Document Detail


Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites.
MedLine Citation:
PMID:  16771965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The use of azathioprine (AZA) in the treatment of autoimmune diseases during pregnancy are believed to be relatively safe, particularly taking into account the potential risks for mother and fetus should the underlying disease become active due to withdrawal of this thiopurine. However, essential evidence on the safety of AZA use during pregnancy is lacking. The determination of the intrauterine exposure to maternal AZA use may provide additional and crucial insights into the safety and teratogenicity of this drug. METHODS: We describe three patients with Crohn's disease and autoimmune hepatitis who were treated with AZA throughout all trimesters of their pregnancies. Thiopurine metabolites (6-thioguaninenucleotides (6-TGN) and 6-methylmercaptopurine (6-MMP)) were measured in the red blood cells (RBC) of mother and infant directly after delivery. RESULTS: The 6-TGN concentration was slightly lower in the RBC of the infant than the mother. No 6-MMP could be detected in the infant. CONCLUSION: The placenta forms a (relative) barrier to AZA and its metabolites. Intrauterine exposure to 6-TGN may be minimized by careful therapeutic drug monitoring of the mother during pregnancy.
Authors:
Nanne K H de Boer; Soeresh V A Jarbandhan; Peer de Graaf; Chris J J Mulder; Ruurd M van Elburg; Adriaan A van Bodegraven
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  101     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-14     Completed Date:  2006-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1390-2     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Azathioprine / therapeutic use*
Crohn Disease / blood,  drug therapy*
Female
Hepatitis, Autoimmune / blood,  drug therapy*
Humans
Immunosuppressive Agents / therapeutic use*
Maternal-Fetal Exchange*
Pregnancy
Thionucleotides / blood*
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Thionucleotides; 446-86-6/Azathioprine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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