Mercaptopurine
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Mercaptopurine Transaminitis in patients with skewed thiopurine metabolism: 2 case reports Two brothers, with skewed thiopurine metabolism, developed transaminitis while receiving mercaptopurine for ulcerative colitis [routes and frequencies of administration not stated]. A 22-year-old man, who had not achieved durable remission of ulcerative colitis with corticosteroids and mesalazine, started mercaptopurine 50mg to enable steroid withdrawal, after tests revealed normal thiopurine methyltransferase (TMPT) activity. However, during attempts to increase his mercaptopurine dose [dose not stated], his ALT level rose to a maximum of 114 U/L without clinical symptoms [duration of treatment to reaction onset not stated]. Tests revealed a 6-methylmercaptopurine (6-MMP) concentration of 13 477 pmol/8 ×108 RBC and a subtherapeutic concentration of 6-thioguanine nucleotide (6-TGN) of
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