Modulatory effect of quercetin on azathioprine induced toxic changes was studied in spleen of experimental animals. Azathioprine treatment caused an increase in serum albumin/globin ratio and a decrease in total protein in spleen tissue. An increase in a membrane bound ATPases was also noted. Supplementation of quercetin with azathioprine increased the protein content and lowered the activities...

Current guidelines support the use of corticosteroids and azathioprine as one possible treatment strategy for idiopathic pulmonary fibrosis (IPF). However, some patients with genetic polymorphisms of thiopurine methyltransferase (TPMT) are at risk of severe azathioprine myelotoxicity. The current authors present the case of an 85-yr-old Caucasian male with IPF who developed diffuse alveolar hae...

Azathioprine induced profound myelosuppression linked to TPMT deficiency has now been documented in many patient groups, including those with Crohn's disease. At the start of azathioprine or mercaptopurine therapy, measurement of TPMT activity has a role in identifying the 1 in 300 patients who are at risk of severe myelosuppression when treated with standard thiopurine dosages. During the init...

BACKGROUND Owing to adverse pharmacokinetics, azathioprine treatment may fail to induce a satisfactory clinical response in systemic connective tissue diseases. The major intracellular cytotoxic metabolites of azathioprine are 6-thioguanine nucleotides (6TGNs). METHODS To assess whether the erythrocyte accumulation of 6TGN is a clinically applicable index for monitoring azathioprine treatment...

BACKGROUND Mycophenolate mofetil has replaced azathioprine in many transplant centers, but data on hard outcomes such as graft and patient survival are lacking. METHODS We analyzed graft and patient survival of the 1219 first renal allograft recipients at the Medical University of Vienna who were treated with azathioprine or mycophenolate mofetil over the past decade. Cox's proportional hazar...

BACKGROUND AND PURPOSE To evaluate the association between the use of azathioprine and risk of cancer in patients with non-thymoma myasthenia gravis (MG) in a nationwide setting. METHODS Case-control study based on population-based registries. Cases were patients with MG with a first time diagnosis of cancer (except non-melanoma skin cancer) registered during 2000-2009, and controls were pati...

Objective: In this prospective study, we examined the association between azathioprine dose, levels of its phosphoribosylated metabolites, and the activity of thiopurine methyltransferase in patients with multiple sclerosis (MS). Materials/Methods: Clinical data and blood samples were collected from 27 MS patients who were undergoing azathioprine treatment. In red blood cells, thiopurine methyl...

The efficacy of azathioprine and mercaptopurine is well established in the treatment of active Crohn’s disease and as a long-term maintenance therapy to prevent relapse in both Crohn’s disease and ulcerative colitis.1 Approximately 15% of patients treated with azathioprine or mercaptopurine have adverse reactions. While some of these reactions are dose-dependent, others, including pancreatitis,...

BACKGROUND Clinical manifestations of hypersensitivity to azathioprine may mimic symptoms of the initial disease. We report 5 cases of peculiar skin hypersensitivity reactions to azathioprine in patients with inflammatory bowel disease. OBSERVATIONS In 5 patients with a recent azathioprine regimen, manifestations appeared between 8 and 18 days after drug introduction. All patients had a high ...

Azathioprine has been used as an immunosuppressant for over 20 years in cancer chemotherapy, organ transplantation and diseases with confirmed or suspected immune mechanisms. A hypersensitivity reaction manifesting as fever, rash, myalgia and a neutrophil leucocytosis occurring about 2 weeks after exposure is well documented and has been confirmed by challenge testing. Hypotensive reactions are...