Z Hallaji; Sh Shams Davatchi; M Vali Khani; N Ghandi; M Kar Bakhsh Davari; M Hedayati; AR Firooz
Volume 9, Issue 3 , 2006, , Pages 204-210
Abstract
Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. ...
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Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. TPMT activity can provide a rational basis to determine suitable dose of azathioprine, theoretically. The aim of this study was to evaluate the clinical relevancy of this hypothesis in PV patients.Materials and Methods: In this cross sectional study in Razi Hospital, the activity of TPMT in the red blood cells of 52 PV patients who received azathioprine for at least 12 months and 29 PV patients who did not receive this drug was measured and correlated to the clinical response and side effects observed.Results:The mean of TPMT activity was not significantly different in patients with unfavourable response, comparing to patients with favorable response to azathioprine (P=0.087). No relationship was observed between total dose of corticosteroid and TPMT activity (r=0.089, P=0.583). There was no difference between the mean of TPMT activity in patients receiving azathioprine and those not receiving this drug (P=0.36).Conclusion: A direct relationship was not observed between TPMT activity and clinical efficacy and side effects in PV patients under treatment with azathioprine. Larger prospective studies in more homogenous patients are needed to evaluate the clinical relevance of TPMT polymorphism and to determine accurate azathioprine dosing guidelines based on TPMT activity.
MJ Nazemi; SN Emadi; S Toosi
Volume 8, suppl , 2004, , Pages 5-10
Abstract
Cyclosporin and azathioprine are immunosuppressive drugs, used widely in kidney transplant patients. A significant association between immunosuppressive therapy and multiple warts was described several years ago. There are also some reports of sebaceous gland hyperplasia in kidney transplant patients ...
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Cyclosporin and azathioprine are immunosuppressive drugs, used widely in kidney transplant patients. A significant association between immunosuppressive therapy and multiple warts was described several years ago. There are also some reports of sebaceous gland hyperplasia in kidney transplant patients receiving cyclosporin. We report herein a 57-year-old woman who developed multiple warts on her hands and feet, lower lid syringomas, sebaceous gland hyperplasia of forehead and multiple mucosal irritation fibromas on tongue after kidney transplantation and a long course of treatment with oral cyclosporin, azathioprine and prednisolone since 6 years ago.
