February 26, 2016 at 1:48 pm #111372
First- “Should we test TPMT enzyme levels before starting azathioprine?
Richard VS1, Al-Ismail D, Salamat A. Author information Abstract
Thiopurine methyltransferase (TPMT) is the main enzyme responsible for inactivating toxic products of azathioprine (AZA) metabolism. Patients with homozygous deficiency of this enzyme have no enzyme activity and ideally should not be given AZA. Patients with heterozygous deficiency have 50% of enzyme activity and have been shown to respond well and tolerate half a standard dose. We describe a patient with homozygous deficiency of TPMT who developed life threatening neutropenic sepsis, and advocate that all patients should be tested for TPMT activity prior to starting AZA therapy.
Author’s last sentence sums it up- get tested before beginning Imuran.
Second: “Azathioprine may increase your risk of developing certain types of cancer, especially skin cancer and lymphoma (cancer that begins in the cells that fight infection).” Also, “Azathioprine can cause a decrease in the number of blood cells in your bone marrow, which may cause serious or life-threatening” infections.
I recall some references along the lines of ‘…watch your white blood cell count closely when taking azathioprine…”March 14, 2016 at 10:53 am #111389
7 IVIG in 2015, 9 IVIG this year. Then Imuran. I was not tested. My bone marrow quit producing all its stuff. All my blood work showed horrible. They stopped Imuran and my Bone marrow still has not recovered. Ive had past Cancer and Kidney disease both are problems whereby you don’t take this med. Going to see an Oncologist today to see if he has answers or knows anything about this drug,
I have read the two references above and later today I’ll report the problems as the last reference recomends.March 14, 2016 at 8:06 pm #111390
You have already taken Imuran so the first warning, the enzyme check, would not apply to you. If you haven’t had a bone marrow exam, perhaps one will be recommended.
Here is a link to the Mayo clinic:
The purpose of the bone marrow exam is to check and see if the marrow is producing the components it should be making.
good luck with your quest and your Oncologist meeting.
Consider seeing a Hematologist. Maybe the Oncologist is a Hematologist.
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