mercaptopurine and Myasthenia-Gravis

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Animals; Antilymphocyte Serum; Azathioprine; Cyclophosphamide; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunosuppressive Agents; Mercaptopurine; Methotrexate; Multiple Sclerosis; Myasthenia Gravis; Polyradiculopathy; Thymectomy

Prednisolone, 6-mercaptopurine, and pyridostigmine bromide are co-administered together to treat a neuromuscular autoimmune disease called myasthenia gravis. Prednisolone and 6-mercaptopurine are immunosuppressant drugs. 6-Mercaptopurine is the active form of the pro-drug azathioprine. Pyridostigmine bromide is a cholinesterase enzyme inhibitor. Curently, green characteristics are taken into account by analysts when they develop new methods.. The spectra of the three compounds and plasma are highly overlapped, so this study aims to remove this overlap and determine the three components quantitatively in raw powders and spiked human plasma using green methods.. Two multivariate updated chemometric models called principle component analysis and partial least-squares were developed. Three greenness assessment tools: the eco-scale, the analytical greenness metric approach, and the green analytical method index, were used to evaluate the greenness behavior of the generated models.. The two models were verified in accordance with Food and Drug Administration requirements, and the results were within acceptable limits. In addition they are relatively green in accordance with the abovementioned greenness evaluation tools.. The developed models succeeded in determining the proposed drugs in their tertiary combinations and spiked human plasma with satisfactory precision, accuracy, and good greenness behavior.. Two ecologically evaluated, multivariate spectrophotometric methods were developed for the determination of pyridostigmine bromide, 6-mercaptopurine, and prednisolone in spiked human plasma.

Topics: Chemometrics; Humans; Mercaptopurine; Myasthenia Gravis; Prednisolone; Pyridostigmine Bromide; United States

A patient with myasthenia gravis is described who exhibited hypersensitivity including an apparent acute exacerbation of the underlying disorder when treated with azathioprine. 6-mercaptoprine (6-MP) also produced hypersensitivity which, in contrast, did not manifest as a myasthenic exacerbation.

Topics: Azathioprine; Drug Hypersensitivity; Humans; Male; Mercaptopurine; Middle Aged; Myasthenia Gravis

A woman with myasthenia gravis and a thymoma did not respond sufficiently to thymectomy. She was treated with 6-mercaptopurine. Withdrawal of this treatment was several times followed by an aggravation of myasthenic symptoms. After more than 12 1/2 years treatment she developed Ph1-positive chronic myeloid leukemia (CML). No other case of CML following immunosuppressive treatment has been described. Because the therapeutic agent is potentially leukemogenic, the possibility cannot be definitely excluded that the development of CML is not a mere coincidence.

Topics: Chromosomes, Human, 21-22 and Y; Female; Humans; Immunosuppressive Agents; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Myasthenia Gravis; Thymectomy

Topics: Adrenocorticotropic Hormone; Adult; Antibodies; Antilymphocyte Serum; Azathioprine; Cholinesterase Inhibitors; Drug Resistance; Female; Fluorescent Antibody Technique; Humans; Immunity, Cellular; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Muscle Proteins; Myasthenia Gravis; Myosins; Remission, Spontaneous; Thymoma; Thymus Hyperplasia; Thymus Neoplasms

Topics: Adult; Autoimmune Diseases; Azathioprine; Blood Cell Count; Busulfan; Cyclophosphamide; Female; Humans; Hypersensitivity, Delayed; Immunosuppressive Agents; Male; Melphalan; Mercaptopurine; Methotrexate; Myasthenia Gravis

Topics: Adolescent; Adult; Age Factors; Agranulocytosis; Aminopterin; Azathioprine; Chemical and Drug Induced Liver Injury; Cholinesterase Inhibitors; Dactinomycin; Drug Synergism; Female; Humans; Immunosuppressive Agents; Male; Mercaptopurine; Methotrexate; Middle Aged; Myasthenia Gravis; Time Factors