mercaptopurine and Hypersensitivity

Topics: Anatomy; Arthritis; Autoantibodies; Betamethasone; Dexamethasone; Dihydroxyphenylalanine; Epidemiology; Histoplasmosis; Hypersensitivity; Melanoma; Mercaptopurine; Oxyphenbutazone; p-Methoxy-N-methylphenethylamine; Phenothiazines; Physiology; Prednisolone; Prednisone; Sarcoidosis; Toxicology; Toxoplasmosis; Triamcinolone; Uvea; Uveitis; Virus Diseases

Topics: Antimetabolites, Antineoplastic; Child; Exanthema; Excipients; Humans; Hypersensitivity; Male; Mercaptopurine; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Starch; Tablets

Hypersensitivity reactions to 6-mercaptopurine (6-MP) or azathioprine occur during the treatment of inflammatory bowel disease (IBD), raising significant diagnostic and therapeutic challenges. Charts of 591 patient with IBD treated with 6-MP in a single center were retrospectively reviewed. All allergic reactions were recorded along with results of rechallenge, desensitization, and subsequent course of IBD. Sixteen (2.7%) allergic reactions to 6-MP were noted, with fever being the most common (14 cases). Nine of these were rechallenged with 6-MP with recurrence of the same symptoms. Azathioprine was tried in six patients and in five the same symptoms recurred. Four patients underwent successful desensitization to either 6-MP or azathioprine; all four plus another patient who tolerated direct switch to azathioprine entered long-term remission. Among the remaining 11, 5 required surgery, 2 are well on methotrexate, and 4 have chronic symptoms while being treated with other medications. If an allergic reaction to 6-MP occurs during the treatment of IBD, direct switching to azathioprine is probably not justified. Instead, desensitization to either 6-MP or azathioprine should be attempted. Patients who can tolerate these medications after previous allergic reactions have improved outcomes compared with patients who resort to other forms of treatment.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Azathioprine; Desensitization, Immunologic; Female; Humans; Hypersensitivity; Immunosuppressive Agents; Inflammatory Bowel Diseases; Male; Mercaptopurine; Middle Aged; Retrospective Studies

Topics: Animals; Cattle; Cornea; Eye Diseases; Female; Hypersensitivity; Male; Mercaptopurine; Rabbits; Serum Albumin, Bovine

Topics: Angioedema; Asthma; Depression, Chemical; Dermatitis, Atopic; Desensitization, Immunologic; Histamine H1 Antagonists; Humans; Hypersensitivity; Mercaptopurine; Pyrrolidines; Rhinitis, Allergic, Seasonal; Skin Tests; Urticaria; Xanthenes

Topics: Absorption; Animals; Chromium Isotopes; Cortisone; Erythrocytes; Eye Diseases; Hemoglobins; Hemorrhage; Hypersensitivity; Infections; Inflammation; Injections; Iron; Mercaptopurine; Prednisolone; Rabbits; Uveitis; Vitreous Body

Topics: Animals; Antibody Formation; Cornea; Hypersensitivity; Immune Sera; Mercaptopurine; Mice; Rabbits; Serum Albumin, Bovine

Topics: Animals; Cornea; Hypersensitivity; Immunosuppressive Agents; Mercaptopurine; Rabbits; Serum Albumin, Bovine

Topics: gamma-Globulins; Hypersensitivity; Hypersensitivity, Delayed; Immunity; Mechlorethamine; Mercaptopurine; Ovalbumin; Rabbits; Research; Skin Tests

Topics: Antibody Formation; Humans; Hypersensitivity; Hypersensitivity, Delayed; Leukocyte Count; Leukocytes; Mercaptopurine; Pharmacology

Topics: Child; Drug Hypersensitivity; Hypersensitivity; Mercaptopurine; Phenytoin; Prednisolone; Seizures; Toxicology

Topics: Agammaglobulinemia; Alanine Transaminase; Animals; Antimetabolites; Autoimmune Diseases; Clinical Enzyme Tests; Encephalomyelitis; Hepatitis; Hypersensitivity; Lupus Erythematosus, Systemic; Mercaptopurine; National Institutes of Health (U.S.); Nephrosis; Nephrotic Syndrome; Prednisone; Skin Tests; United States

Topics: Anemia; Anemia, Hemolytic; Female; Hemorrhage; Humans; Hypersensitivity; Mercaptopurine; Postpartum Hemorrhage; Postpartum Period

Experimental uveitis in rabbits was induced by single intraocular antigen injection. Treatment with 6-MP for 14 days suppressed the allergic inflammation and antibody response. A good correlation was demonstrated between the degree of uveitis and the antibody titer.

Topics: Animals; Antibody Formation; Antigens; Hypersensitivity; Mercaptopurine; Rabbits; Uveitis

1. 6-Mercaptopurine (6-MP) prevents experimental allergic encephalomyelitis (EAE) during the period of drug administration in both rabbits and guinea pigs. The disease is suppressed even when treatment is started as late as the 5th day after antigenic stimulation in guinea pigs and the 12th day in rabbits. 2. After discontinuation of 6-MP treatment, there is a latent period before the disease is noted. The length of this latent period is not modified by the duration of 6-MP treatment. 3. The effect of 6-MP on EAE is not the result of leukopenia, non-specific toxicity and debilitation, anti-inflammatory activity, or mere masking of clinical signs of the disease. It is, rather, the result of 6-MP's specific anti-immunologic activity. 4. The effects of 6-MP on antibody production, delayed hypersensitivity, and EAE are compared. This provides indirect evidence for the importance of circulating antibody in the pathogenesis of EAE. 5. The important considerations in the use of 6-MP are discussed and the possible usefulness of 6-MP in human neurologic diseases is considered.

Topics: Animals; Antibody Formation; Antigens; Encephalomyelitis; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Humans; Hypersensitivity; Mercaptopurine; Rabbits

Topics: Carbutamide; Hypersensitivity; Mercaptopurine; Sulfanilamide; Sulfanilamides; Urea