van Moorsel S A W, Bevers N, Meurs M, van Rossum L K, Hooymans P M, Wong D R
*Department of Clinical Pharmacy and Toxicology, Zuyderland Medical Centre, Sittard-Geleen;†Department of Pediatrics, Zuyderland Medical Centre, Heerlen; and‡Department of Clinical Pharmacy and Toxicology, Zuyderland Medical Centre, Heerlen, the Netherlands.
Ther Drug Monit. 2017 Feb;39(1):1-4. doi: 10.1097/FTD.0000000000000366.
We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase-deficient IBD patients.
我们描述了一例接受硫唑嘌呤治疗的儿科患者，其先前未被诊断出纯合子硫嘌呤甲基转移酶（TPMT）缺乏，导致骨髓毒性硫嘌呤代谢物水平升高。在频繁的硫嘌呤代谢物测量和密切临床监测的指导下，该患者成功地以每周一次50毫克的极低硫唑嘌呤剂量（标准剂量的4%）进行治疗。我们证明，对于儿科硫嘌呤甲基转移酶缺乏的炎症性肠病患者，硫唑嘌呤治疗仍可能是一种有效且安全的治疗选择。
