Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 July 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Intrauterine exposure of thiopurine therapy in pregnant patients with IBD

The latest issue of Gut investigates intrauterine exposure and the pharmacology of conventional thiopurine therapy in pregnant patients with inflammatory bowel disease.

News image

Several studies have demonstrated a favourable safety profile for thiopurine use for inflammatory bowel disease (IBD) during pregnancy.

Dr Bindia Jharap and colleagues from the Netherlands performed a study in pregnant patients with IBD who were using thiopurines, in order to determine the influence of pregnancy on thiopurine metabolism and to assess intrauterine exposure of the fetus to thiopurines.

Female patients with IBD receiving steady-state thiopurines and planning a pregnancy were prospectively enrolled.

6-Thioguanine nucleotide (6-TGN) and methylmercaptopurine concentrations were determined, combined with routine laboratory tests, before, during and after pregnancy.

Thiopurine metabolites were measured in umbilical cord blood immediately after delivery.

About 60% of the infants were born with anemia
Gut

The researchers evaluated 30 patients who were using azathioprine or mercaptopurine.

During pregnancy, the team observed that the median 6-TGN decreased over time.

While methylmercaptopurine increased, without causing myelotoxicity or hepatotoxicity.

After delivery, both 6-TGN and methylmercaptopurine levels returned to preconception baseline levels.

The team found that fetal 6-TGN concentrations correlated positively with maternal 6-TGN levels.

No methylmercaptopurine was detected in the newborns, except one born with pancytopenia and high alkaline phosphatase activity, and the mother of this infant had severe pre-eclampsia.

The team noted that all infants had normal Apgar scores, but 60% had anemia at birth.

The research team observed no major congenital abnormalities.

Dr Jharap's team comments, "Pregnancy has a major effect on maternal thiopurine metabolism."

"In utero the unborn child is exposed to 6-TGN, but not to methylmercaptopurine."

"About 60% of the infants were born with anemia, which raises the question whether infants should be tested for possible anemia immediately after birth."

Gut 2014; 63: 451-457 
19 February 2014

Go to top of page Email this page Email this page to a colleague

 26 July 2016 
Post-infectious IBS after C. diff
 26 July 2016 
Neighborhood variation in the use of laparoscopy for colon cancer
 26 July 2016 
Gut microbiota and IBD
 25 July 2016 
Steroids in eosinophilic esophagitis
 25 July 2016 
Prevention of post-ERCP pancreatitis
 25 July 2016 
Antibiotic prophylaxis for open colectomies
 22 July 2016 
Duodenal villous atrophy and celiac disease
 22 July 2016 
Fecal calprotectin and IBD
 22 July 2016 
Upper GI lesions at primary diagnosis in IBD
 21 July 2016 
Radiofrequency ablation in Barrett's
 21 July 2016 
HCV eradication and inflammation in cirrhotic patients
 21 July 2016 
Surveillance of Barrett's
 20 July 2016 
Nonselective β-blockers and survival in cirrhosis
 20 July 2016 
Adolescent body mass index and and colorectal cancer risk
 20 July 2016 
Genetic biomarkers and IBD treatment response
 19 July 2016 
Prevention of chemotherapy-induced nausea and vomiting
 19 July 2016 
Screening diabetic patients for NAFLD
 19 July 2016 
Longterm clinical follow-up of living liver donors
 18 July 2016 
Rectal neuroendocrine tumors
 18 July 2016 
Liver stiffness measurement in chronic liver disease
 18 July 2016 
Liver cancer prediction scores in Hep B
 15 July 2016 
Patient reported outcomes in celiac disease
 15 July 2016 
Tonsillectomy and IBD risk
 15 July 2016 
Trainee IBD education in the USA
 14 July 2016 
Screening for familial pancreatic cancer
 14 July 2016 
Fecal calprotection for IBD prognosis
 14 July 2016 
Perianal surgery risk in Crohn's
 13 July 2016 
Psychological comorbidity and postinfectious IBS
 13 July 2016 
Lung transplant outcomes in Hep C
 13 July 2016 
Graft selection strategy in living donor liver transplants
 12 July 2016 
Therapy for iron deficiency anemia in IBD
 12 July 2016 
Surveillance endoscopy in Barrett's esophagus
 12 July 2016 
Treatment of pediatric acute liver failure
 11 July 2016 
Transition to adulthood in celiac disease
 11 July 2016 
Disturbed sleep and IBS
 11 July 2016 
Factors that influence access to liver transplant
 08 July 2016 
Mortality and peptic ulcers
 08 July 2016 
Statins and cirrhosis in Hep B
 08 July 2016 
Genetic risk score and body mass index
 07 July 2016 
Predicting food triggers in eosinophilic esophagitis
 07 July 2016 
Predictors fecal transplant failure in C. diff infection
 07 July 2016 
Extraperitoneal vs transperitoneal colostomy for hernia
 06 July 2016 
Therapies for Hep B cure
 06 July 2016 
Hospital volume and liver cancer survival
 06 July 2016 
Adverse events after outpatient colonoscopy
 05 July 2016 
Colorectal surgery and dialysis
 05 July 2016 
Non-invasive scoring systems for fibrosis in NAFLD
 05 July 2016 
Exercise and gastroesophageal reflux
 04 July 2016 
Guidelines on PPI and NSAID prescription
 04 July 2016 
Rectal cancer surgery checklist
 04 July 2016 
Autoimmunity in eosinophilic esophagitis and families
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 01 July 2016 
Aspirin and colorectal cancer
 30 June 2016 
Staging system for familial adenomatous polyposis
 30 June 2016 
Antibiotics in children and obesity
 30 June 2016 
IBS-type symptoms in pediatric IBD
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 29 June 2016 
Progression to esophageal carcinoma in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us