6-Thioguanine for Crohn's disease during pregnancy: thiopurine metabolite measurements in both mother and child

Scand J Gastroenterol. 2005 Nov;40(11):1374-7. doi: 10.1080/00365520510024089.

Abstract

6-Thioguanine is used as an escape thiopurine for treating inflammatory bowel disease patients intolerant or refractory to azathioprine, 6-mercaptopurine or methotrexate. Case reports show conflicting data on the use of 6-thioguanine throughout pregnancy. The administration of the standard thiopurines is believed to be relatively safe. We describe two patients with Crohn's disease treated with low-dose 6-thioguanine during all trimesters of their pregnancies. The pregnancies resulted in two healthy infants: without congenital abnormalities, laboratory signs of myelosuppression or hepatocellular injury. Thiopurine metabolites were measured in mother and infant. Significantly lower levels of 6-thioguaninenucleotides were found in the erythrocytes of the infant compared to the mother (ratio 1:12). Further studies are needed to determine the clinical importance of thiopurine metabolite measurements during pregnancy in mother and child.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Crohn Disease / diagnosis*
  • Crohn Disease / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Maternal-Fetal Exchange / drug effects*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy*
  • Pregnancy Outcome*
  • Pregnancy, High-Risk
  • Risk Assessment
  • Severity of Illness Index
  • Thioguanine / administration & dosage*
  • Thioguanine / adverse effects

Substances

  • Thioguanine