Azathioprine Use During Pregnancy: Unexpected Intrauterine Exposure to Metabolites

• DOI: 10.1111/j.1572-0241.2006.00538.x
• Publication Date: 2006-04-29T22:18:50Z
• Authors: Nanne K H de Boer; Soeresh V A Jarba...; Peer de Graaf; Chris J J Mulder; Ruurd M van Elburg; Adriaan A van Bod...
• Keywords: Thiopurine methyltransferase

INTRODUCTION The use of azathioprine (AZA) in the treatment autoimmune diseases during pregnancy are believed to be relatively safe, particularly taking into account potential risks for mother and fetus should underlying disease become active due withdrawal this thiopurine. However, essential evidence on safety AZA is lacking. determination intrauterine exposure maternal may provide additional crucial insights teratogenicity drug. METHODS We describe three patients with Crohn's hepatitis who were treated throughout all trimesters their pregnancies. Thiopurine metabolites (6-thioguaninenucleotides (6-TGN) 6-methylmercaptopurine (6-MMP)) measured red blood cells (RBC) infant directly after delivery. RESULTS 6-TGN concentration was slightly lower RBC than mother. No 6-MMP could detected infant. CONCLUSION placenta forms a (relative) barrier its metabolites. Intrauterine minimized by careful therapeutic drug monitoring pregnancy.