Analysis of Thiopurine S-Methyltransferase Genotypes in Japanese Patients with Inflammatory Bowel Disease
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概要
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Background and Aims Myelosuppression observed in patients with inflammatory bowel disease (IBD) treated with azathioprine (AZA) has been attributed to low thiopurine S-methyltransferase (TPMT) activity. TPMT activity is dependent on the genetic polymorphism of high-versus low-metabolizing alleles. We investigated the association between TPMT genotypes and myelosuppression in Japanese IBD patients. Methods Forty-one healthy volunteers and 70 IBD patients (UC, n = 50; CD, n = 20) were recruited. All IBD patients were treated with AZA. The TPMT genotypes were determined by polymerase-chain reaction-restriction fragment length polymorphism (PCR-RFLP) analyses. Results One healthy volunteer showed a heterozygous mutation of TPMT*1/*3C. All other volunteers and the 70 IBD patients were of the wild alleleotype (TPMT*1/*1). In the IBD patients, 7 patients developed leucopenia (<3,000 /μL). One of them developed severe leucopenia (<1,000 μL) with agranulocytosis on day 14 after drug initiation. Conclusion TPMT mutations are not associated with myelosuppression in Japanese IBD patients. Even in IBD patients with a wild TPMT genotype, clinicians should pay attention for the possible development of myelosuppression.
著者
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Fujiyama Yoshihide
Department Of Gastroenterology And Hematology Shiga University Of Medical Science
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SASAKI MASAYA
Department of Internal Medicine, Shiga University of Medical Science
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Andoh Akira
Department Of Gastroenterology Shiga University Of Medical Sciencs
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BAN Hiromitsu
Department of Medicine, Shiga University of Medical Science
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Saito Yasuharu
Department Of Medicine Shiga University Of Medical Science
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Ban Hiromitsu
Department Of Medicine Shiga University Of Medical Science
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Tsujikawa Tomoyuki
Department of Internal Medicine, Shiga University of Medical Science
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Tanaka Aiko
Department of Medicine, Shiga University of Medical Science
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