Azathioprine: An immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance has been listed as a known carcinogen. (Merck Index, 11th ed)Tablets: Solid dosage forms, of varying weight, size, and shape, which may be molded or compressed, and which contain a medicinal substance in pure or diluted form. (Dorland, 28th ed)Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient.Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging.6-Mercaptopurine: An antimetabolite antineoplastic agent with immunosuppressant properties. It interferes with nucleic acid synthesis by inhibiting purine metabolism and is used, usually in combination with other drugs, in the treatment of or in remission maintenance programs for leukemia.Heart Transplantation: The transference of a heart from one human or animal to another.Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species.Grooming: An animal's cleaning and caring for the body surface. This includes preening, the cleaning and oiling of feathers with the bill or of hair with the tongue.Kidney Transplantation: The transference of a kidney from one human or animal to another.Waxes: A plastic substance deposited by insects or obtained from plants. Waxes are esters of various fatty acids with higher, usually monohydric alcohols. The wax of pharmacy is principally yellow wax (beeswax), the material of which honeycomb is made. It consists chiefly of cerotic acid and myricin and is used in making ointments, cerates, etc. (Dorland, 27th ed)Meningitis, Cryptococcal: Meningeal inflammation produced by CRYPTOCOCCUS NEOFORMANS, an encapsulated yeast that tends to infect individuals with ACQUIRED IMMUNODEFICIENCY SYNDROME and other immunocompromised states. The organism enters the body through the respiratory tract, but symptomatic infections are usually limited to the lungs and nervous system. The organism may also produce parenchymal brain lesions (torulomas). Clinically, the course is subacute and may feature HEADACHE; NAUSEA; PHOTOPHOBIA; focal neurologic deficits; SEIZURES; cranial neuropathies; and HYDROCEPHALUS. (From Adams et al., Principles of Neurology, 6th ed, pp721-2)Myasthenia Gravis: A disorder of neuromuscular transmission characterized by weakness of cranial and skeletal muscles. Autoantibodies directed against acetylcholine receptors damage the motor endplate portion of the NEUROMUSCULAR JUNCTION, impairing the transmission of impulses to skeletal muscles. Clinical manifestations may include diplopia, ptosis, and weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles. THYMOMA is commonly associated with this condition. (Adams et al., Principles of Neurology, 6th ed, p1459)Thymectomy: Surgical removal of the thymus gland. (Dorland, 28th ed)Prednisone: A synthetic anti-inflammatory glucocorticoid derived from CORTISONE. It is biologically inert and converted to PREDNISOLONE in the liver.Meningitis: Inflammation of the coverings of the brain and/or spinal cord, which consist of the PIA MATER; ARACHNOID; and DURA MATER. Infections (viral, bacterial, and fungal) are the most common causes of this condition, but subarachnoid hemorrhage (HEMORRHAGES, SUBARACHNOID), chemical irritation (chemical MENINGITIS), granulomatous conditions, neoplastic conditions (CARCINOMATOUS MENINGITIS), and other inflammatory conditions may produce this syndrome. (From Joynt, Clinical Neurology, 1994, Ch24, p6)Cryptococcus neoformans: A species of the fungus CRYPTOCOCCUS. Its teleomorph is Filobasidiella neoformans.Myasthenia Gravis, Autoimmune, Experimental: Any autoimmune animal disease model used in the study of MYASTHENIA GRAVIS. Injection with purified neuromuscular junction acetylcholine receptor (AChR) (see RECEPTORS, CHOLINERGIC) components results in a myasthenic syndrome that has acute and chronic phases. The motor endplate pathology, loss of acetylcholine receptors, presence of circulating anti-AChR antibodies, and electrophysiologic changes make this condition virtually identical to human myasthenia gravis. Passive transfer of AChR antibodies or lymphocytes from afflicted animals to normals induces passive transfer experimental autoimmune myasthenia gravis. (From Joynt, Clinical Neurology, 1997, Ch 54, p3)Cryptococcosis: Infection with a fungus of the species CRYPTOCOCCUS NEOFORMANS.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Mycophenolic Acid: An antibiotic substance derived from Penicillium stoloniferum, and related species. It blocks de novo biosynthesis of purine nucleotides by inhibition of the enzyme inosine monophosphate dehydrogenase. Mycophenolic acid is important because of its selective effects on the immune system. It prevents the proliferation of T-cells, lymphocytes, and the formation of antibodies from B-cells. It also may inhibit recruitment of leukocytes to inflammatory sites. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1301)Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Methyltransferases: A subclass of enzymes of the transferase class that catalyze the transfer of a methyl group from one compound to another. (Dorland, 28th ed) EC 2.1.1.Cyclosporine: A cyclic undecapeptide from an extract of soil fungi. It is a powerful immunosupressant with a specific action on T-lymphocytes. It is used for the prophylaxis of graft rejection in organ and tissue transplantation. (From Martindale, The Extra Pharmacopoeia, 30th ed).Mesalamine: An anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed)Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Colitis, Ulcerative: Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN.Anti-Inflammatory Agents, Non-Steroidal: Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.Sulfasalazine: A drug that is used in the management of inflammatory bowel diseases. Its activity is generally considered to lie in its metabolic breakdown product, 5-aminosalicylic acid (see MESALAMINE) released in the colon. (From Martindale, The Extra Pharmacopoeia, 30th ed, p907)Gastrointestinal Agents: Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion.Aminosalicylic Acids: A group of 2-hydroxybenzoic acids that can be substituted by amino groups at any of the 3-, 4-, 5-, or 6-positions.Library Services: Services offered to the library user. They include reference and circulation.Libraries, MedicalImmune System: The body's defense mechanism against foreign organisms or substances and deviant native cells. It includes the humoral immune response and the cell-mediated response and consists of a complex of interrelated cellular, molecular, and genetic components.Immunity, Innate: The capacity of a normal organism to remain unaffected by microorganisms and their toxins. It results from the presence of naturally occurring ANTI-INFECTIVE AGENTS, constitutional factors such as BODY TEMPERATURE and immediate acting immune cells such as NATURAL KILLER CELLS.Meristem: A group of plant cells that are capable of dividing infinitely and whose main function is the production of new growth at the growing tip of a root or stem. (From Concise Dictionary of Biology, 1990)Arthritis, Rheumatoid: A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated.Antirheumatic Agents: Drugs that are used to treat RHEUMATOID ARTHRITIS.Steroids: A group of polycyclic compounds closely related biochemically to TERPENES. They include cholesterol, numerous hormones, precursors of certain vitamins, bile acids, alcohols (STEROLS), and certain natural drugs and poisons. Steroids have a common nucleus, a fused, reduced 17-carbon atom ring system, cyclopentanoperhydrophenanthrene. Most steroids also have two methyl groups and an aliphatic side-chain attached to the nucleus. (From Hawley's Condensed Chemical Dictionary, 11th ed)Adrenal Cortex HormonesArthritisGlucocorticoids: A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system.Lupus Nephritis: Glomerulonephritis associated with autoimmune disease SYSTEMIC LUPUS ERYTHEMATOSUS. Lupus nephritis is histologically classified into 6 classes: class I - normal glomeruli, class II - pure mesangial alterations, class III - focal segmental glomerulonephritis, class IV - diffuse glomerulonephritis, class V - diffuse membranous glomerulonephritis, and class VI - advanced sclerosing glomerulonephritis (The World Health Organization classification 1982).Lupus Erythematosus, Systemic: A chronic, relapsing, inflammatory, and often febrile multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes. It is of unknown etiology, but is thought to represent a failure of the regulatory mechanisms of the autoimmune system. The disease is marked by a wide range of system dysfunctions, an elevated erythrocyte sedimentation rate, and the formation of LE cells in the blood or bone marrow.Nephritis: Inflammation of any part of the KIDNEY.Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro.Inflammatory Bowel Diseases: Chronic, non-specific inflammation of the GASTROINTESTINAL TRACT. Etiology may be genetic or environmental. This term includes CROHN DISEASE and ULCERATIVE COLITIS.Crohn Disease: A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.Colitis: Inflammation of the COLON section of the large intestine (INTESTINE, LARGE), usually with symptoms such as DIARRHEA (often with blood and mucus), ABDOMINAL PAIN, and FEVER.Protective Clothing: Clothing designed to protect the individual against possible exposure to known hazards.Ointment Bases: Various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons; vehicles for medicinal substances intended for external application; there are four classes: hydrocarbon base, absorption base, water-removable base and water-soluble base; several are also emollients.Sunscreening Agents: Chemical or physical agents that protect the skin from sunburn and erythema by absorbing or blocking ultraviolet radiation.Urination: Discharge of URINE, liquid waste processed by the KIDNEY, from the body.Clothing: Fabric or other material used to cover the body.Psoralens: Linear furanocoumarins which are found in many PLANTS, especially UMBELLIFERAE and RUTACEAE, as well as PSORALEA from which they were originally discovered. They can intercalate DNA and, in an UV-initiated reaction of the furan portion, alkylate PYRIMIDINES, resulting in PHOTOSENSITIVITY DISORDERS.Platelet Transfusion: The transfer of blood platelets from a donor to a recipient or reinfusion to the donor.Sun Protection Factor: A measure of relative protection provided by SUNSCREENING AGENTS against burns due to ultraviolet (UV) radiation from a light source.Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight.Sunlight: Irradiation directly from the sun.Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands.Sarcoidosis, Pulmonary: Sarcoidosis affecting predominantly the lungs, the site most frequently involved and most commonly causing morbidity and mortality in sarcoidosis. Pulmonary sarcoidosis is characterized by sharply circumscribed granulomas in the alveolar, bronchial, and vascular walls, composed of tightly packed cells derived from the mononuclear phagocyte system. The clinical symptoms when present are dyspnea upon exertion, nonproductive cough, and wheezing. (Cecil Textbook of Medicine, 19th ed, p431)Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of TETRAHYDROFOLATE DEHYDROGENASE and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA.Respiratory Function Tests: Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Lung: Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Hepatitis, Autoimmune: A chronic self-perpetuating hepatocellular INFLAMMATION of unknown cause, usually with HYPERGAMMAGLOBULINEMIA and serum AUTOANTIBODIES.Pregnancy Outcome: Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.DenmarkPregnancy Complications: Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.Pregnancy, Animal: The process of bearing developing young (EMBRYOS or FETUSES) in utero in non-human mammals, beginning from FERTILIZATION to BIRTH.Abnormalities, Drug-Induced: Congenital abnormalities caused by medicinal substances or drugs of abuse given to or taken by the mother, or to which she is inadvertently exposed during the manufacture of such substances. The concept excludes abnormalities resulting from exposure to non-medicinal chemicals in the environment.Hepatitis: INFLAMMATION of the LIVER.Hepatitis C: INFLAMMATION of the LIVER in humans caused by HEPATITIS C VIRUS, a single-stranded RNA virus. Its incubation period is 30-90 days. Hepatitis C is transmitted primarily by contaminated blood parenterally, and is often associated with transfusion and intravenous drug abuse. However, in a significant number of cases, the source of hepatitis C infection is unknown.Hepatitis B: INFLAMMATION of the LIVER in humans caused by a member of the ORTHOHEPADNAVIRUS genus, HEPATITIS B VIRUS. It is primarily transmitted by parenteral exposure, such as transfusion of contaminated blood or blood products, but can also be transmitted via sexual or intimate personal contact.Liver Cirrhosis, Biliary: FIBROSIS of the hepatic parenchyma due to obstruction of BILE flow (CHOLESTASIS) in the intrahepatic or extrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC; BILE DUCTS, EXTRAHEPATIC). Primary biliary cirrhosis involves the destruction of small intra-hepatic bile ducts and bile secretion. Secondary biliary cirrhosis is produced by prolonged obstruction of large intrahepatic or extrahepatic bile ducts from a variety of causes.Hepatitis A: INFLAMMATION of the LIVER in humans caused by a member of the HEPATOVIRUS genus, HUMAN HEPATITIS A VIRUS. It can be transmitted through fecal contamination of food or water.Skin DiseasesDermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment.Dermatitis, Atopic: A chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. It is manifested by lichenification, excoriation, and crusting, mainly on the flexural surfaces of the elbow and knee. In infants it is known as infantile eczema.Dermatologic Agents: Drugs used to treat or prevent skin disorders or for the routine care of skin.ArchivesJournal Impact Factor: A quantitative measure of the frequency on average with which articles in a journal have been cited in a given period of time.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Antibodies, Monoclonal: Antibodies produced by a single clone of cells.Arthrography: Roentgenography of a joint, usually after injection of either positive or negative contrast medium.Pemphigus: Group of chronic blistering diseases characterized histologically by ACANTHOLYSIS and blister formation within the EPIDERMIS.Pemphigoid, Bullous: A chronic and relatively benign subepidermal blistering disease usually of the elderly and without histopathologic acantholysis.Pemphigoid, Benign Mucous Membrane: A chronic blistering disease with predilection for mucous membranes and less frequently the skin, and with a tendency to scarring. It is sometimes called ocular pemphigoid because of conjunctival mucous membrane involvement.Dermabrasion: The mechanical planing of the SKIN with sand paper, emery paper, or wire brushes, to promote reepithelialization and smoothing of skin disfigured by ACNE scars or dermal NEVI.Cosmetic Techniques: Procedures for the improvement or enhancement of the appearance of the visible parts of the body.Allopurinol: A XANTHINE OXIDASE inhibitor that decreases URIC ACID production. It also acts as an antimetabolite on some simpler organisms.Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi.Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.Pharmaceutical Services, Online: Pharmacy services accessed via electronic means.Counterfeit Drugs: Drugs manufactured and sold with the intent to misrepresent its origin, authenticity, chemical composition, and or efficacy. Counterfeit drugs may contain inappropriate quantities of ingredients not listed on the label or package. In order to further deceive the consumer, the packaging, container, or labeling, may be inaccurate, incorrect, or fake.Legislation, Pharmacy: Laws and regulations, pertaining to the field of pharmacy, proposed for enactment or enacted by a legislative body.Pharmacies: Facilities for the preparation and dispensing of drugs.Drug and Narcotic Control: Control of drug and narcotic use by international agreement, or by institutional systems for handling prescribed drugs. This includes regulations concerned with the manufacturing, dispensing, approval (DRUG APPROVAL), and marketing of drugs.Prescription Drugs: Drugs that cannot be sold legally without a prescription.Drug Information Services: Services providing pharmaceutic and therapeutic drug information and consultation.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Pharmacy: The practice of compounding and dispensing medicinal preparations.Pancreatitis: INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.New Zealand: A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)Genome-Wide Association Study: An analysis comparing the allele frequencies of all available (or a whole GENOME representative set of) polymorphic markers in unrelated patients with a specific symptom or disease condition, and those of healthy controls to identify markers associated with a specific disease or condition.Polymorphism, Single Nucleotide: A single nucleotide variation in a genetic sequence that occurs at appreciable frequency in the population.Genetic Loci: Specific regions that are mapped within a GENOME. Genetic loci are usually identified with a shorthand notation that indicates the chromosome number and the position of a specific band along the P or Q arm of the chromosome where they are found. For example the locus 6p21 is found within band 21 of the P-arm of CHROMOSOME 6. Many well known genetic loci are also known by common names that are associated with a genetic function or HEREDITARY DISEASE.Pancreatitis, Chronic: INFLAMMATION of the PANCREAS that is characterized by recurring or persistent ABDOMINAL PAIN with or without STEATORRHEA or DIABETES MELLITUS. It is characterized by the irregular destruction of the pancreatic parenchyma which may be focal, segmental, or diffuse.Genotype: The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS.Genetic Predisposition to Disease: A latent susceptibility to disease at the genetic level, which may be activated under certain conditions.Pancreatitis, Acute Necrotizing: A severe form of acute INFLAMMATION of the PANCREAS characterized by one or more areas of NECROSIS in the pancreas with varying degree of involvement of the surrounding tissues or organ systems. Massive pancreatic necrosis may lead to DIABETES MELLITUS, and malabsorption.Aegle: A plant genus of the family RUTACEAE.Ileitis: Inflammation of any segment of the ILEUM and the ILEOCECAL VALVE.Paneth Cells: Differentiated epithelial cells of the INTESTINAL MUCOSA, found in the basal part of the intestinal crypts of Lieberkuhn. Paneth cells secrete GROWTH FACTORS, digestive enzymes such as LYSOZYME and antimicrobial peptides such as cryptdins (ALPHA-DEFENSINS) into the crypt lumen.Ileum: The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.alpha-Defensins: DEFENSINS found in azurophilic granules of neutrophils and in the secretory granules of intestinal PANETH CELLS.Nod2 Signaling Adaptor Protein: A NOD signaling adaptor protein that contains two C-terminal leucine-rich domains which recognize bacterial PEPTIDOGLYCAN. It signals via an N-terminal capase recruitment domain that interacts with other CARD SIGNALING ADAPTOR PROTEINS such as RIP SERINE-THEONINE KINASES. The protein plays a role in the host defense response by signaling the activation of CASPASES and the MAP KINASE SIGNALING SYSTEM. Mutations of the gene encoding the nucleotide oligomerization domain 2 protein have been associated with increased susceptibility to CROHN DISEASE.Saint Vincent and the Grenadines: A self-governing state of the Windward Islands in the West Indies, comprising Saint Vincent and the northern islets of the Grenadines. Its capital is Kingstown. It is one of the original homes of the Carib Indians supposed to have been sighted by Columbus in 1498. It was in English hands from 1627 till held by the French 1779-83. Saint Vincent subsequently became a British possession and, with other nearby British territories, was administered by the Governor of the Windward Islands till 1959. It attained a measure of independence in 1969 but achieved full independence as Saint Vincent and the Grenadines in 1979. Saint Vincent was the 4th century Spanish martyr on whose feast day Columbus discovered the island. Grenadines is derived from the Spanish kingdom of Granada. (From Webster's New Geographical Dictionary, 1988, p1054 & The Europa World Year Book 1993, p2441)Thioguanine: An antineoplastic compound which also has antimetabolite action. The drug is used in the therapy of acute leukemia.Biological Therapy: Treatment of diseases with biological materials or biological response modifiers, such as the use of GENES; CELLS; TISSUES; organs; SERUM; VACCINES; and humoral agents.Psychology, Experimental: The branch of psychology which seeks to learn more about the fundamental causes of behavior by studying various psychologic phenomena in controlled experimental situations.Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.Hydrocortisone: The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Tablets, Enteric-Coated: Tablets coated with material that delays release of the medication until after they leave the stomach. (Dorland, 28th ed)Antibodies, Antinuclear: Autoantibodies directed against various nuclear antigens including DNA, RNA, histones, acidic nuclear proteins, or complexes of these molecular elements. Antinuclear antibodies are found in systemic autoimmune diseases including systemic lupus erythematosus, Sjogren's syndrome, scleroderma, polymyositis, and mixed connective tissue disease.Tongue, FissuredElectronic Mail: Messages between computer users via COMPUTER COMMUNICATION NETWORKS. This feature duplicates most of the features of paper mail, such as forwarding, multiple copies, and attachments of images and other file types, but with a speed advantage. The term also refers to an individual message sent in this way.Mitogen-Activated Protein Kinases: A superfamily of PROTEIN-SERINE-THREONINE KINASES that are activated by diverse stimuli via protein kinase cascades. They are the final components of the cascades, activated by phosphorylation by MITOGEN-ACTIVATED PROTEIN KINASE KINASES, which in turn are activated by mitogen-activated protein kinase kinase kinases (MAP KINASE KINASE KINASES).JNK Mitogen-Activated Protein Kinases: A subgroup of mitogen-activated protein kinases that activate TRANSCRIPTION FACTOR AP-1 via the phosphorylation of C-JUN PROTEINS. They are components of intracellular signaling pathways that regulate CELL PROLIFERATION; APOPTOSIS; and CELL DIFFERENTIATION.Calcium-Calmodulin-Dependent Protein Kinases: A CALMODULIN-dependent enzyme that catalyzes the phosphorylation of proteins. This enzyme is also sometimes dependent on CALCIUM. A wide range of proteins can act as acceptor, including VIMENTIN; SYNAPSINS; GLYCOGEN SYNTHASE; MYOSIN LIGHT CHAINS; and the MICROTUBULE-ASSOCIATED PROTEINS. (From Enzyme Nomenclature, 1992, p277)Mitochondria: Semiautonomous, self-reproducing organelles that occur in the cytoplasm of all cells of most, but not all, eukaryotes. Each mitochondrion is surrounded by a double limiting membrane. The inner membrane is highly invaginated, and its projections are called cristae. Mitochondria are the sites of the reactions of oxidative phosphorylation, which result in the formation of ATP. They contain distinctive RIBOSOMES, transfer RNAs (RNA, TRANSFER); AMINO ACYL T RNA SYNTHETASES; and elongation and termination factors. Mitochondria depend upon genes within the nucleus of the cells in which they reside for many essential messenger RNAs (RNA, MESSENGER). Mitochondria are believed to have arisen from aerobic bacteria that established a symbiotic relationship with primitive protoeukaryotes. (King & Stansfield, A Dictionary of Genetics, 4th ed)p38 Mitogen-Activated Protein Kinases: A mitogen-activated protein kinase subfamily that regulates a variety of cellular processes including CELL GROWTH PROCESSES; CELL DIFFERENTIATION; APOPTOSIS; and cellular responses to INFLAMMATION. The P38 MAP kinases are regulated by CYTOKINE RECEPTORS and can be activated in response to bacterial pathogens.Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein.Enzyme Activation: Conversion of an inactive form of an enzyme to one possessing metabolic activity. It includes 1, activation by ions (activators); 2, activation by cofactors (coenzymes); and 3, conversion of an enzyme precursor (proenzyme or zymogen) to an active enzyme.Mitogen-Activated Protein Kinase Kinases: A serine-threonine protein kinase family whose members are components in protein kinase cascades activated by diverse stimuli. These MAPK kinases phosphorylate MITOGEN-ACTIVATED PROTEIN KINASES and are themselves phosphorylated by MAP KINASE KINASE KINASES. JNK kinases (also known as SAPK kinases) are a subfamily.Benzoyl Peroxide: A peroxide derivative that has been used topically for BURNS and as a dermatologic agent in the treatment of ACNE and POISON IVY DERMATITIS. It is used also as a bleach in the food industry.Methylmethacrylate: The methyl ester of methacrylic acid. It polymerizes easily to form POLYMETHYL METHACRYLATE. It is used as a bone cement.Proton Pump Inhibitors: Compounds that inhibit H(+)-K(+)-EXCHANGING ATPASE. They are used as ANTI-ULCER AGENTS and sometimes in place of HISTAMINE H2 ANTAGONISTS for GASTROESOPHAGEAL REFLUX.Sperm Count: A count of SPERM in the ejaculum, expressed as number per milliliter.Phytotherapy: Use of plants or herbs to treat diseases or to alleviate pain.Drugs, Chinese Herbal: Chinese herbal or plant extracts which are used as drugs to treat diseases or promote general well-being. The concept does not include synthesized compounds manufactured in China.Pharmacists: Those persons legally qualified by education and training to engage in the practice of pharmacy.Life Style: Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed)United States Food and Drug Administration: An agency of the PUBLIC HEALTH SERVICE concerned with the overall planning, promoting, and administering of programs pertaining to maintaining standards of quality of foods, drugs, therapeutic devices, etc.United StatesEthanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in ALCOHOLIC BEVERAGES.Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.Colon: The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.ParisFrance: A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Systemic Vasculitis: A heterogeneous group of diseases characterized by inflammation and necrosis of the blood vessel walls.Faculty, Medical: The teaching staff and members of the administrative staff having academic rank in a medical school.Polyarteritis Nodosa: A form of necrotizing non-granulomatous inflammation occurring primarily in medium-sized ARTERIES, often with microaneurysms. It is characterized by muscle, joint, and abdominal pain resulting from arterial infarction and scarring in affected organs. Polyarteritis nodosa with lung involvement is called CHURG-STRAUSS SYNDROME.Faculty: The teaching staff and members of the administrative staff having academic rank in an educational institution.Scleroderma, Systemic: A chronic multi-system disorder of CONNECTIVE TISSUE. It is characterized by SCLEROSIS in the SKIN, the LUNGS, the HEART, the GASTROINTESTINAL TRACT, the KIDNEYS, and the MUSCULOSKELETAL SYSTEM. Other important features include diseased small BLOOD VESSELS and AUTOANTIBODIES. The disorder is named for its most prominent feature (hard skin), and classified into subsets by the extent of skin thickening: LIMITED SCLERODERMA and DIFFUSE SCLERODERMA.Churg-Strauss Syndrome: Widespread necrotizing angiitis with granulomas. Pulmonary involvement is frequent. Asthma or other respiratory infection may precede evidence of vasculitis. Eosinophilia and lung involvement differentiate this disease from POLYARTERITIS NODOSA.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Prodrugs: A compound that, on administration, must undergo chemical conversion by metabolic processes before becoming the pharmacologically active drug for which it is a prodrug.Nitroreductases: Enzymes which reduce nitro groups (NITRO COMPOUNDS) and other nitrogenous compounds.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Genetic Therapy: Techniques and strategies which include the use of coding sequences and other conventional or radical means to transform or modify cells for the purpose of treating or reversing disease conditions.

Primary biliary cirrhosis associated with membranous glomerulonephritis. (1/943)

A 33-year-old woman was admitted to our department for evaluation of liver dysfunction and proteinuria. A liver biopsy specimen showed ductular proliferation and moderate portal fibrosis indicating stage II primary biliary cirrhosis. A renal biopsy specimen showed mild to moderate mesangial cell proliferation without crescent formation or interstitial nephritis. Immunofluorescent staining revealed deposition of immunoglobulin G (IgG), third component of complement (C3), and Clq on glomerular basement membranes. The findings indicated stage I membranous glomerulonephritis. Administration of ursodesoxycholic acid together with prednisolone, azathioprine, and dipyridamole decreased proteinuria and improved cholestatic liver dysfunction.  (+info)

Reduced kidney transplant rejection rate and pharmacoeconomic advantage of mycophenolate mofetil. (2/943)

BACKGROUND: Several multinational controlled clinical trials have shown that triple therapy immunosuppressive regimens which include mycophenolate mofetil (MMF), cyclosporin A (CSA) and steroids (S) are superior compared with conventional regimens which include azathioprine (AZA), CSA and S, mainly because MMF reduces the rate of acute rejection episodes in the first 6 months after kidney transplantation. Post-marketing studies are useful to evaluate the general applicability and costs of MMF-based immunosuppressive regimens. METHODS: Based on the excellent results of the published controlled clinical trials, we have changed the standard triple therapy immunosuppressive protocol (AZA+CSA+S) to an MMF-based regimen (MMF+CSA+S) at our centre. To analyse the impact of this change in regimen, we have monitored 6-month patient and graft survival, rejection rate, serum creatinine and CSA levels, as well as the costs of the immunosuppressive and anti-rejection treatments, in 40 consecutive renal transplant recipients (MMF group) and have compared the data with 40 consecutive patients transplanted immediately prior to the change in regimen (AZA group). RESULTS: Recipient and donor characteristics were similar in the AZA and MMF groups. Patient survival (37/40; 92.5% in the AZA group vs 38/40; 95% in the MMF group), graft survival (36/40 vs 36/40; both 90%) and serum creatinine (137+/-56 vs 139+/-44 micromol/l) after 6 months were not significantly different. However, the rate of acute rejection episodes (defined as a rise in creatinine without other obvious cause and treated at least with pulse steroids) was significantly reduced with MMF from 60 to 20% (P=0.0005). The resulting cost for rejection treatment was lowered 8-fold (from sFr. 2113 to 259 averaged per patient) and the number of transplant biopsies was lowered > 3-fold in the MMF group. The cost for the immunosuppressive therapy was increased 1.5-fold with MMF (from sFr. 5906 to 9231 per patient for the first 6 months). CONCLUSIONS: The change from AZA to MMF resulted in a significant reduction in early rejection episodes, resulting in fewer diagnostic procedures and rehospitalizations. The optimal long-term regimen in terms of patient and pharmacoeconomic benefits remains to be defined.  (+info)

Long-term results of pancreas transplantation under tacrolius immunosuppression. (3/943)

BACKGROUND: The long-term safety and efficacy of tacrolimus in pancreas transplantation has not yet been demonstrated. The observation of prolonged pancreatic graft function under tacrolimus would indicate that any potential islet toxicity is short-lived and clinically insignificant. We report herein the results of pancreas transplantation in patients receiving primary tacrolimus immunosuppression for a minimum of 2 years. METHODS: From July 4, 1994 until April 18, 1996, 60 patients received either simultaneous pancreas-kidney transplant (n=55), pancreas transplant only (n=4), or pancreas after kidney transplantation (n=1). Baseline immunosuppression consisted of tacrolimus and steroids without antilymphocyte induction. Azathioprine was used as a third agent in 51 patients and mycophenolate mofetil in 9. Rejection episodes within the first 6 months occurred in 48 (80%) patients and were treated with high-dose corticosteroids. Antilymphocyte antibody was required in eight (13%) patients with steroid-resistant rejection. RESULTS: With a mean follow-up of 35.1+/-5.9 months (range: 24.3-45.7 months), 6-month and 1-, 2-, and 33-year graft survival is 88%, 82%, 80%, and 80% (pancreas) and 98%, 96%, 93%, and 91% (kidney), respectively. Six-month and 1-, 2-, and 3-year patient survival is 100%, 98%, 98%, and 96.5%. Mean fasting glucose is 91.6+/-13.8 mg/dl, and mean glycosylated hemoglobin is 5.1+/-0.7% (normal range: 4.3-6.1%). Mean tacrolimus dose is 6.5+/-2.6 mg/day and mean prednisone dose 2.0+/-2.9 mg/day at follow-up. Complete steroid withdrawal was possible in 31 (65%) of the 48 patients with functioning pancreases. CONCLUSIONS: These data show for the first time that tacrolimus is a safe and effective long-term primary agent in pancreas transplantation and provides excellent long-term islet function without evidence of toxicity while permitting steroid withdrawal in the majority of patients.  (+info)

Pediatric renal transplantation under tacrolimus-based immunosuppression. (4/943)

BACKGROUND: Tacrolimus has been used as a primary immunosuppressive agent in adult and pediatric renal transplant recipients, with reasonable outcomes. Methods. Between December 14, 1989 and December 31, 1996, 82 pediatric renal transplantations alone were performed under tacrolimus-based immunosuppression without induction anti-lymphocyte antibody therapy. Patients undergoing concomitant or prior liver and/or intestinal transplantation were not included in the analysis. The mean recipient age was 10.6+/-5.2 years (range: 0.7-17.9). Eighteen (22%) cases were repeat transplantations, and 6 (7%) were in patients with panel-reactive antibody levels over 40%. Thirty-four (41%) cases were with living donors, and 48 (59%) were with cadaveric donors. The mean donor age was 27.3+/-14.6 years (range: 0.7-50), and the mean cold ischemia time in the cadaveric cases was 26.5+/-8.8 hr. The mean number of HLA matches and mismatches was 2.8+/-1.2 and 2.9+/-1.3; there were five (6%) O-Ag mismatches. The mean follow-up was 4.0+/-0.2 years. RESULTS: The 1- and 4-year actuarial patient survival was 99% and 94%. The 1- and 4-year actuarial graft survival was 98% and 84%. The mean serum creatinine was 1.1+/-0.5 mg/dl, and the corresponding calculated creatinine clearance was 88+/-25 ml/min/1.73 m2. A total of 66% of successfully transplanted patients were withdrawn from prednisone. In children who were withdrawn from steroids, the mean standard deviation height scores (Z-score) at the time of transplantation and at 1 and 4 years were -2.3+/-2.0, -1.7+/-1.0, and +0.36+/-1.5. Eighty-six percent of successfully transplanted patients were not taking anti-hypertensive medications. The incidence of acute rejection was 44%; between December 1989 and December 1993, it was 63%, and between January 1994 and December 1996, it was 23% (P=0.0003). The incidence of steroid-resistant rejection was 5%. The incidence of delayed graft function was 5%, and 2% of patients required dialysis within 1 week of transplantation. The incidence of cytomegalovirus was 13%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 12%. The incidence of early Epstein-Barr virus-related posttransplant lymphoproliferative disorder (PTLD) was 9%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 4%. All of the early PTLD cases were treated successfully with temporary cessation of immunosuppression and institution of antiviral therapy, without patient or graft loss. CONCLUSIONS: These data demonstrate the short- and medium-term efficacy of tacrolimus-based immunosuppression in pediatric renal transplant recipients, with reasonable patient and graft survival, routine achievement of steroid and anti-hypertensive medication withdrawal, gratifying increases in growth, and, with further experience, a decreasing incidence of both rejection and PTLD.  (+info)

Global biventricular dysfunction in patients with asymptomatic coronary artery disease may be caused by myocarditis. (5/943)

BACKGROUND: The causal role of asymptomatic critical coronary artery obstruction in patients presenting with severe global biventricular dysfunction but no evidence of myocardial infarction is uncertain. METHODS AND RESULTS: Among 291 patients aged >40 years undergoing a noninvasive (2-dimensional echocardiography) and invasive (catheterization, coronary angiography, and biventricular endomyocardial biopsy, 6 to 8 samples/patient) cardiac study because of progressive heart failure (New York Heart Association functional class III or IV) with global biventricular dysfunction and no history of myocardial ischemic events, 7 patients (2.4%; 7 men; mean age, 49+/-6.9 years) had severe coronary artery disease (3 vessels in 4 patients; 2 vessels in 1 patient, proximal occlusion of left anterior descending coronary artery in 2 patients). Left ventricular end-diastolic diameter and ejection fraction by 2-dimensional echocardiography were 73+/-10.5 mm and 23+/-6.5%, respectively, and right ventricular end-diastolic diameter and ejection fraction were 39+/-7 mm and 29+/-7.2%, respectively. Biopsy specimens showed extensive lymphocytic infiltrates with focal myocytolysis meeting the Dallas criteria for myocarditis in all patients (in 5 patients with and 2 patients without fibrosis). Cardiac autoantibodies were detected with indirect immunofluorescence in the serum of 2 patients with active myocarditis. The 2 patients with active inflammation received prednisone (1 mg. kg-1. d-1 for 4 weeks followed by 0.33 mg. kg-1. d-1 for 5 months) and azathioprine (2 mg. kg-1. d-1 for 5 months) in addition to conventional drug therapy for heart failure. At 8-month overall follow-up, cardiac volume and function improved considerably in immunosuppressed patients but remained unchanged in conventionally treated patients, of whom 1 died. CONCLUSIONS: Global biventricular dysfunction in patients with severe asymptomatic coronary artery disease and no evidence of previous myocardial infarction may be caused by myocarditis. Histologic findings may influence the treatment.  (+info)

Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn's disease. (6/943)

BACKGROUND: Crohn's disease is a chronic inflammatory disease of the alimentary tract. Azathioprine is an effective agent in the management of chronic active Crohn's disease leading to long term remission of disease activity. Such treatment leads to limited efficacy or side effects in a small subset of patients. AIMS: To compare efficacy and side effects of treatment with azathioprine plus corticosteroids versus mycophenolate mofetil (MMF) plus corticosteroids in patients with chronic active Crohn's disease. METHODS: Seventy patients with chronic active Crohn's disease (Crohn's disease activity index (CDAI) greater than 150) were randomised for treatment with azathioprine/cortisone or MMF/cortisone. Corticosteroid dosage was tapered according to a standard protocol. Disease activity was monitored by clinical scores after one, two, three, and six months. RESULTS: Treatment of patients with moderately active (CDAI 150-300) Crohn's disease with MMF/cortisone led to a significant reduction in clinical activity scores comparable to treatment with azathioprine/cortisone. Treatment of patients with highly active Crohn's disease (CDAI greater than 300) with MMF/cortisone caused significant suppression of clinical activity earlier than azathioprine/cortisone treatment. Treatment with MMF/cortisone was associated with few adverse effects. CONCLUSION: Treatment of chronic active Crohn's disease with MMF plus cortisone appears to be effective and well tolerated and should be considered in patients allergic to azathioprine or in whom azathioprine has failed.  (+info)

Intestinal T lymphocytes of different rat strains in immunotoxicity. (7/943)

In order to study the intestinal mucosal immune cells, with emphasis on single T lymphocytes, an inventory was made of single and organized lymphocytes in the epithelium and lamina propria of the small intestines of untreated Wistar, Fischer 344, and Lewis rats. The single and organized lymphocytes were examined microscopically. In addition, the single lymphocytes in the epithelium (IEL) and lamina propria (LPL) were analyzed by flow cytometry. Next, the use of flow cytometry analysis was explored to detect changes in the IEL T-lymphocyte population in subacute oral studies with the immunomodulating agents azathioprine and hexachlorobenzene. Untreated random-bred Wistar rats exhibited a large interindividual variability in IEL composition, while the variability was small in inbred Fischer 344 and Lewis rats. The explorative study with the 2 model immunomodulating compounds demonstrated that hexachlorobenzene increased the number of intraepithelial T lymphocytes with CD8+ phenotype at the cost of T cells with CD4+ phenotype in Lewis rats. Azathioprine did not induce distinct effects on the percentages of IEL. The data indicate that the intraepithelial lymphocytes in the intestines are a potential target for orally administered immunomodulating compounds and should therefore receive more attention in toxicologic pathology studies.  (+info)

Bone loss in long-term renal transplantation: histopathology and densitometry analysis. (8/943)

BACKGROUND: There is little information of the spectrum and factors implicated in the bone loss in long-term renal transplantation, and virtually no data using both histomorphometric and densitometric analysis. METHODS: Twenty-three males and 22 females (13 postmenopausal) were studied with a bone biopsy and densitometry. Sixteen patients were on cyclosporine A monotherapy, 20 on azathioprine + prednisolone, and 9 on cyclosporine A + prednisolone or triple therapy. The mean time after transplantation was 127 +/- 70 months. RESULTS: No group had a significant decrease in bone mineral density (BMD) of the axial skeleton compared with an age- and sex-matched normal population. Compared with sex-matched young controls, osteopenia was observed in all groups at the femoral neck (except premenopausal women and triple therapy) and in the triple-therapy group at the L1-L4 spine region. At the distal radius, osteopenia was found in all the groups. Histopathological diagnosis was mixed uremic osteodystrophy in 46.5%, adynamic bone in 23.2%, hyperparathyroid disease in 13.9%, and normal bone in 16.3%. The diagnosis was not different according to immunosuppressive therapy, but men tended to show more mixed uremic bone disease. There was no significant difference in BMD between histopathological subtypes. In general, patients showed slight osteoclast function increase, osteoblast function decrease, and marked retardation of dynamic parameters. The cyclosporine A monotherapy group had a significantly lower appositional rate than azathioprine + prednisolone. Men had a significantly lower bone volume than women, and premenopausal women had a significantly lower mineralizing surface than postmenopausal women and men. In the multivariate analysis, male gender, time after transplantation, old age, and time on dialysis prior to transplantation were significant predictive factors for a negative effect on bone mass. CONCLUSIONS: Long-term renal transplant-patients showed reduced BMD in both trabecular and cortical bone. This reduction in BMD was not as severe as in short-term reports and was associated with osteoclast stimulation, osteoblast suppression, and retardation of mineral apposition and bone formation rates. Bone mass loss was not different between the immunosuppression therapy groups. Male gender and age were the strongest predictive factors for low bone mass.  (+info)

*Azathioprine

... can cause birth defects. A 2003 population-based study in Denmark showed that the use of azathioprine and related ... "Azathioprine". Merriam-Webster Dictionary. "Azathioprine". The American Society of Health-System Pharmacists. Archived from the ... American Society of Health-System Pharmacists (January 2012). "Azathioprine, Azathioprine Sodium". AHFS Drug Information 2012. ... with azathioprine, but the combination with other DMARDs is not recommended. Azathioprine has been used in the management of ...

*Management of Crohn's disease

Azathioprine and 6-MP may be useful for the following indications: Maintenance therapy with azathioprine or 6-mercaptopurine ... Azathioprine is listed by the United States FDA as a human carcinogen. However, it confers considerably less morbidity and ... Azathioprine treatment may lead to rare but life-threatening side effects. The rare side effects include leukopenia or ... "Azathioprine. Report on Carcinogens, Fourteenth Edition" (PDF). ntp.niehs.nih.gov. Retrieved 2017-06-17. Hanauer, Stephen B; ...

*Belimumab

... azathioprine, $468; and mycophenolate mofetil, $1,224. In the UK, the National Institute for Health and Care Excellence (NICE) ...

*Mercaptopurine

Azathioprine "Mercaptopurine". The American Society of Health-System Pharmacists. Archived from the original on 20 December ... Nørgård, B.; L. Pedersen; K. Fonager; S. Rasmussen; H. Sørensen (March 2003). "Azathioprine, mercaptopurine and birth outcome: ... or the related azathioprine) showed a seven-fold incidence of fetal abnormalities as well as a 20-fold increase in miscarriage ... "Pharmacogenetics of azathioprine in inflammatory bowel disease: a role for glutathione-S-transferase?". World J Gastroenterol. ...

*GlaxoSmithKline

". "John R. Vane - Biographical". Maltzman JS, Koretzky GA (April 2003). "Azathioprine: old drug, new actions". J. Clin. Invest ...

*Purine analogue

Azathioprine is the main immunosuppressive cytotoxic substance. It is widely used in transplantations to control rejection ...

*Polish plait

Following Azathioprine-induced Pancytopenia". International Journal of Trichology. 2 (2): 110-2. doi:10.4103/0974-7753.77523. ...

*Granulomatous mastitis

Colchicine, azathioprine and NSAIDs have also been used. Garcia-Rodiguez JA, Pattullo A (2013). "Idiopathic granulomatous ...

*Nodular regenerative hyperplasia

May 2005). "Azathioprine induced nodular regenerative hyperplasia in IBD patients". Gastroenterol. Clin. Biol. 29 (5): 600-3. ... It can be a complication of azathioprine therapy. Hartleb, Marek; Gutkowski, Krzysztof; Milkiewicz, Piotr (2011-03-21). " ... October 2007). "Nodular regenerative hyperplasia in patients with inflammatory bowel disease treated with azathioprine". Gut. ... cytotoxic drugs like azathioprine, mercaptopurine, thioguanine, antiretroviral drugs for HIV like didanosine and vitamin A. The ...

*Sarcoidosis

Azathioprine treatment can also lead to liver damage. Leflunomide is being used as a replacement for methotrexate, possibly due ... Medications such as methotrexate, chloroquine, or azathioprine may occasionally be used in an effort to decrease the side ... Antimetabolites, also categorized as steroid-sparing agents, such as azathioprine, methotrexate, mycophenolic acid, and ... and azathioprine) used in corticosteroid-refractory sarcoidosis are known teratogens. Konstantinidis, G. (2005). Elsevier's ...

*Feline calicivirus

Corticosteroids or azathioprine may be used for polyarthritis. Stomatitis is very difficult to treat. Antibiotics, ...

*Idiopathic pulmonary fibrosis

Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. NEnglJMed. 2012 May 24;366:1968-77. Commonly used three- ... This study found that the combination of prednisone, azathioprine, and NAC increased the risk of death and hospitalizations and ... to reduce the decline in VC and DLCO over 12 months of follow-up when used in combination with prednisone and azathioprine ( ...

*ADAMTS7

Therapy with steroid-free immunosuppressant azathioprine]". Der Ophthalmologe: Zeitschrift Der Deutschen Ophthalmologischen ...

*Cogan syndrome

These immunosuppressive drugs include methotrexate, cyclophosphamide, cyclosporine or azathioprine. In some cases, combinations ...

*Lymphomatoid granulomatosis

... with case reports of methotrexate and azathioprine), infections such as HIV or chronic viral hepatitis or endogenous T-cell ... "Rituximab for pulmonary lymphomatoid granulomatosis which developed as a complication of methotrexate and azathioprine therapy ... "Lymphomatoid granulomatosis associated with azathioprine therapy in Crohn disease". BMC Gastroenterology. 14: 127. doi:10.1186/ ...

*Drug discovery

... azathioprine) that allowed human organ transplantation; the first drug to induce remission of childhood leukaemia; pivotal anti ...

*Peliosis hepatis

Withdrawal of azathioprine leads to remission in renal transplant; bacillary peliosis responds to antibiotics. In rare ... Haboubi NY, Ali HH, Whitwell HL, Ackrill P (1988). "Role of endothelial cell injury in the spectrum of azathioprine-induced ... Drugs and toxins: Corticosteroids, androgens, azathioprine, tamoxifen The condition is typically asymptomatic and is discovered ... can be related to azathioprine or cyclosporine use, and may be associated with increased risk of transplant rejection. ...

*Immunosuppressive drug

Calcineurin inhibitors and azathioprine have been linked with post-transplant malignancies and skin cancers in organ transplant ... Azathioprine (Prometheus' Imuran), is the main immunosuppressive cytotoxic substance. It is extensively used to control ... These include: folic acid analogues, such as methotrexate purine analogues, such as azathioprine and mercaptopurine pyrimidine ...

*Dermatitis

The most commonly used are ciclosporin, azathioprine, and methotrexate. Light therapy using ultraviolet light has tentative ...

*IMPDH1

Roberts RL, Gearry RB, Barclay ML, Kennedy MA (2007). "IMPDH1 promoter mutations in a patient exhibiting azathioprine ...

*Nitrosoprodenafil

... because of the structural similarity with the mutagenic azathioprine. The final confirmation of the azathioprine/aildenafil ... who suggested the structure was an azathioprine/aildenafil hybrid. This newly suggested structure was dubbed 'mutaprodenafil' ...

*Mycophenolic acid

... is 15 times more expensive than azathioprine. The exact role of mycophenolate vs azathioprine has yet to be ... Compared with azathioprine it has higher incidence of diarrhea, and no difference in risk of any of the other side effects. ... Mycophenolate is potent and can, in many contexts, be used in place of the older anti-proliferative azathioprine. It is usually ... 2004). "Mycophenolate mofetil versus azathioprine for prevention of acute rejection in renal transplantation (MYSS): a ...

*Prurigo nodularis

Another drug a physician may administer is Apo-Azathioprine. Azathioprine, also known by its brand name Imuran, is an ...

*Arteritis

Commonly used cytotoxic agents include azathioprine, methotrexate, or cyclophosphamide. The dose of glucocorticoid medication ...

*Kidney transplantation

Some recipients may instead take ciclosporin, sirolimus, or azathioprine. The risk of early rejection of the transplanted ...
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Multiple sclerosis inteferon pain lidocaine. Muscle or joint pain; nausea azathioprine/imuran joint pain (plus a little update thanks guys. Muscle pain or stiffness. Muscle relaxant - azathioprine 100 mg tabs chords, buy imuran online, it is also used to relieve joint pain and swelling for patients with rheumatoid arthritis. My 50mg dose of imuran is plaguing me with joint pain, muscle pain (maybe) and nausea.. My daughter has experienced growing chest pain and shortness of breath (as the imuran has built up in her system) despite the fact that her chest x-rays, ekg;s; hi everyone, i;m about to start taking imuran for the first time and just wondering dynamo1, i hadn;t heard of the imuran causing joint pain. My hair fell out, i had overwhelming sinus pain, and i caught the cold of the century. My hips are; 16 jun 2017 imuran for treating ulcerative colitis turned out to be full of imuran on top of this i had chills constantly and some stabbing pains in my left side. My husband is currently ...
Azathioprine is well absorbed following oral administration. Maximum serum radioactivity occurs at 1 to 2 hours after oral 35S-azathioprine and decays with a half-life of 5 hours. This is not an estimate of the half-life of azathioprine itself, but is the decay rate for all 35S-containing metabolites of the drug. Because of extensive metabolism, only a fraction of the radioactivity is present as azathioprine. Usual doses produce blood levels of azathioprine, and of mercaptopurine derived from it, which are low (,1 mcg/mL). Blood levels are of little predictive value for therapy since the magnitude and duration of clinical effects correlate with thiopurine nucleotide levels in tissues rather than with plasma drug levels. Azathioprine and mercaptopurine are moderately bound to serum proteins (30%) and are partially dialyzable. (See OVERDOSAGE).. Azathioprine is metabolized to 6-mercaptopurine (6-MP). Both compounds are rapidly eliminated from blood and are oxidized or methylated in erythrocytes ...
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While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
TY - JOUR. T1 - Initiating Azathioprine for Crohns Disease. AU - Levesque, Barrett G.. AU - Loftus, Jr, Edward Vincent. PY - 2012/5. Y1 - 2012/5. N2 - Azathioprine (AZA) and 6-mercaptopurine are therapeutic options for patients with moderate to severe inflammatory Crohns disease. AZA has both a complex metabolism and potential for adverse events that can be clinically challenging. AZA has been shown to maintain remission and reduce corticosteroid use in patients with Crohns disease. There is heterogeneous thiopurine methyltransferase metabolism among patients, which has implications for clinical dosing and risk for adverse events. Routine thiopurine methyltransferase testing before the initiation of AZA will reduce early leukopenia and is mandatory to avoid potentially life-threatening myelotoxicity. Thiopurine metabolite assays may aid in the assessment of adherence and adverse events. Patients who do not respond to AZA therapy may benefit from the addition of biologic therapy or ...
Ive been talking with my nurse practitioner. She really wants me to be on Humira, although my symptoms are currently not too bad. Everything else Ive tried (entocort, pred, asacol)-I had reactions to them. She wants to start me on Imuran for probably six months, then move to Humira. I know Ive read different things on here. Is it true that I should be on the Imuran first to suppress my immune system and have less likelihood of my body developing a resistance to the Humira? Do I need to stay on the Imuran all the while Im on the Humira? She made it sound like I should only be on Imuran for no longer than six months. I know Ive seen people on here that are on Imuran forever and a day and also people on Humira with no Imuran. She also said insurance likely wont approve Humira unless the Imuran is tried first ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
Crohns disease is characterized by inflammation (the changes that happen when tissues in the body are injured) and ulceration (open sores) of the intestines. Crohns disease is treated with medications that decrease inflammation, and reduce diarrhea, abdominal pain and other symptoms of Crohns disease. In addition, Crohns disease can be treated with medications that suppress the immune system (the body system involved in inflammation and infections) or with surgery. This study will investigate the effectiveness of infliximab and azathioprine in the treatment of patients with moderate-to-severe Crohns disease. Infliximab is currently approved by the FDA for the treatment of both Crohns disease and rheumatoid arthritis. Azathioprine, which is an investigational drug, has not been approved by the FDA for the treatment of Crohns disease, but it is a well-established therapy that has been used for many years to treat Crohns disease. This study seeks to determine whether infliximab, azathioprine, or ...
Manage azathioprine drug-drug interactions. Treatment with probenecid is indicated for this patient. Probenecid promotes renal urate excretion and is efficacious in patients who underexcrete uric acid (documented by a 24-hour urine collection) in the setting of a normal estimated glomerular filtration rate (GFR). (Its efficacy is limited in patients with significant decreases of estimated GFR.) Probenecid may increase the risk of kidney stones; therefore, patients taking probenecid must hydrate aggressively and may need to alkalinize their urine, and the drug should be used with caution in patients at high risk for stones (for example, a history of stones or tophaceous gout). This patient has frequent gout attacks in the setting of hyperuricemia and requires urate-lowering therapy. In this setting, probenecid would be both effective and compatible with this patients azathioprine treatment for granulomatosis with polyangiitis. Allopurinol and febuxostat each lower serum urate by inhibiting ...
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Introduction Measuring azathioprine or mercaptopurine (AZA) metabolite levels 6-TGN and 6-MMPN allows identification of patients who are: 1. Non compliant with their medication, 2. On a sub-optimal doe, 3. On a supra-therapeutic dose, 4. Are preferentially metabolising azathioprine to methylated metabolites (6-MMPN:6-TGN ratio , 11).. Our own and others published data demonstrate that measuring metabolite levels in patients failing azathioprine therapy followed by appropriate changes in dosing and/or the addition of allopurinol (with 75% dose reduction in AZA) can result in clinical remission in the majority of patients 1. We report the outcome of the routine measurement of metabolite levels in patients treated with AZA who were in a clinical remission without side effects or abnormal liver function tests (LFTs).. ...
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Although there are no standard guidelines for the treatment of autoimmune blistering diseases, azathioprine has shown good efficacy in acquired autoimmune blistering diseases, and is well tolerated. Side effects of azathioprine normally occur in mild variants. Severe reactions are due to reduced thiopurine S
A list of the side effects of Azathioprine (also called Imuran), a medication that is used in the treatment of inflammatory bowel disease.
Azathioprine lowers your bodys immune system. The immune system helps your body fight infections. The immune system can also fight or reject a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader. Azathioprine is used to prevent your body from rejecting a...
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Belimumab 10 mg/kg IV plus oral azathioprine 2 mg/kg/day; belimumab administered on Days 0, 14, 28, and then every 28 days until the end of the study. If the results in the double-blind period show that belimumab is safe and effective, then participants have the option to continue treatment with belimumab in a 6-month open-label extension phase. Patients who opt to participate in the extension will continue to receive belimumab 10 mg/kg IV every 28 plus oral azathioprine 2 mg/kg/day days for an additional 6 months ...
Methods We performed a genome-wide association study (GWAS, Stage 1) of thiopurine-induced pancreatitis, genotyping 55 UK and Dutch cases and comparing these with 5782 previously genotyped population controls. We genotyped cases using Illumina 670-Quad custom and 1M-Duo SNP arrays. In total, 535 753 SNPs passed quality controls in all Stage 1 samples with a further 384 513 SNPs available for 40 of the cases and 4936 of the controls from the UK. 43 SNPs from 32 independent genomic loci showing evidence of association with thiopurine-induced pancreatitis (PGWAS ,10−4) were included in the design of an autoimmune disease genotyping array (Illumina Immunochip) to facilitate follow-up genotyping. Follow-up (Stage 2) genotyping was performed in 13 New Zealand cases and 47 thiopurine-exposed IBD controls and 12 Spanish cases and 352 population controls.. ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
Im on both. I actually started the Remicade first because I needed to get out of a severe flare - FAST! Then I started the Imuran. Its pretty common practice to be on both from what I understand because the azathioprine helps to reduce the risk of building up antibodies to the mouse proteins in the Remicade - thus rendering the Remicade useless. Ive been on the Remicade for 2+ years and the azathioprine slightly less than that. Ive been doing great! My doc is hoping to wean me off the Remicade completely (not before Humira is approved in case Remicade wont work 2nd time around) and leave me on the Azathioprine. He likes it better this way because he feels there is more long term data on the aza than on the Remicade.. Good luck! Hope it works as well for you as it does for me! :). ...
Several studies and large case series investigated pregnancy outcomes of women exposed to AZA and other immunosuppressants during pregnancy. Most women exposed to AZA during pregnancy were treated following renal transplantation. In more than 400 reported pregnancies, there were very few anomalies reported.5 7 The rate of malformation was not higher than would be expected in the general population and there was no pattern or consistency in the malformations that occurred.. A study of 42 pregnancies of women with autoimmune hepatitis reported that 14 of the pregnancies were exposed to AZA.8 There were no significant differences in the outcomes of these pregnancies versus pregnancies exposed to other drugs. While a small Danish cohort study suggested an increased risk of malformations, prematurity, and perinatal mortality following maternal use of AZA or 6-mercaptopurine during the first trimester of pregnancy,9 the National Transplantation Pregnancy Registry in 2002 did not report increased ...
Ive been having really bad nausea for about a week, especially an hour after I eat or drink anything (other than water). I spoke to a doctor last night and he thinks it could be my Imuran. I went up from 200 to 250mg a day a month ago and I have increased my Humira from once every two weeks to once a week. The doc told me to stop taking the Imuran and that if that was the problem, I should start feeling better in 24 hours. So I didnt take it last night or today, and I still feel just as sick. Its been like 18 hours so far. Im wondering if anyone has had bad nausea from Imuran and if so, how long it took them to feel normal after stopping to take it. Also, did you get sick an hour after eating or drinking anything? That is the time frame for me which is much less than it takes for food to get to where my Crohns problems are (terminal ileum). Im seeing a doctor tomorrow afternoon but would love to hear other peoples related experiences ...
Maintenance therapy with the immunosuppressive agent mycophenolate mofetil (CellCept) was superior to azathioprine in preventing renal relapse among patients with lupus, an international phase III tri
Imuran: Azathioprine belongs to the group of medications known as immunosuppressive agents. It is used to prevent the rejection of kidney transplants and to treat severe rheumatoid arthritis that is not responding to conventional treatment. Azathioprine prevents rejection of kidney transplant and reduces the inflammation and pain in rheumatoid arthritis by suppressing the bodys natural defense, or immune system.
Consumer Medicine InformationWhat is in this leaflet? Please read this leaflet carefully before you start taking IMURAN.This leaflet answers some common questions about IMURAN. It does not contain all of the available information.It does not take the place of talking to your doctor or pharmacist.All medicines have risks and benefits. Your doctor has weighed the risks of you taking IMURAN against the benefits this medicine is expected to have for you.If you have any concerns about taking this medicine,..
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While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctors approval. Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor ...
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Background/Significance: CASE: 68-year-old man with PMH of atrial fibrillation and Crohns disease presented with two days history of fevers 102.8F, chills, nasal congestion and cough with small amount of whitish sputum. He denied abdominal pain, diarrhea, chest pant, joint pain, rash or urticaria. Recently diagnosed with Crohns disease confirmed by colonic biopsy. Treatment was started with Azathioprine and Prednisone.On examination, patient looked ill and was having severe rigors and high grade fevers. Abdominal exam showed mild tenderness of the left lower quadrant on deep palpation without guarding or rebound tenderness and normal bowel sounds. Laboratory date showed normal white count and lactate level. Chest X-ray, urine analysis, and blood culture results were unremarkable. CT scan of the abdomen and pelvis with contrast showed mild intrahepatic biliary dilation with normal common biliary duct and gallbladder and diverticulosis without abscess or any other pathology. Suspecting an intra
Learn about the potential side effects of azathioprine. Includes common and rare side effects information for consumers and healthcare professionals.
What is this medicine? AZATHIOPRINE (ay za THYE oh preen) suppresses the immune system. It is used to prevent organ rejection after a transplant.
Azathioprine has been shown to reduce the steroid requirements of patients with severe rheumatoid arthritis. Twenty-seven patients treated with azathioprine have now been followed up for 30 months. At the end of this period only 10 were still taking the drug. Maximum steroid reduction occurred within the first 12 months of treatment. Some steroid-sparing effect seemed to persist after the drug was stopped. There was no evidence that azathioprine prevented radiological deterioration. No deaths occurred and toxic effects always reversed on stopping the drug.. ...
Chronic treatment with azathioprine, a highly effective anti-inflammatory and immunosuppressive agent, profoundly increases the risk for development of unusually aggressive cutaneous squamous cell carcinoma. Its ultimate metabolite, 6-thioguanine (6-TG) nucleotide, is incorporated in DNA of skin cells, and upon exposure to UVA radiation, causes oxidative stress, followed by damage of DNA and associated proteins. The acetylenic tricyclic bis(cyano enone) TBE-31 is a strong inhibitor of inflammation and a potent inducer of the Keap1/Nrf2/ARE pathway, which orchestrates the expression of a large network of cytoprotective genes. We now report that long-term (five days per week for four weeks) topical daily applications of small (200 nmol) quantities of TBE-31 cause a robust systemic induction of the Keap1/Nrf2/ARE pathway and decreases the 6-TG incorporation in DNA of skin, blood, and liver of azathioprine-treated mice, indicating extraordinary bioavailability and efficacy. In addition, TBE-31, at ...
BACKGROUND:: The value of azathioprine metabolites (6-thioguanine nucleotides [6-TGN]) in monitoring clinical treatment response is still controversially discussed. Data regarding thiopurine metabolite levels and endoscopic improvement are lacking. METHODS:: Data were analyzed post hoc from a 1-year, multicenter, double-blind, double-dummy, randomized trial comparing azathioprine 2.0 to 2.5 mg/kg per day ...
Reflections on getting older: I was always wanted to be a zoologist and decided on medicine when my father became ill. He had chronic renal failure, presumably from an autoimmune disease that started when he was a teenager. He went onto peritoneal dialysis when he was 43; I was 12 at the time. Two years later he was on haemodialysis and 8 years later had a kidney transplant. I go on a lot about expert patients; my dad was the first one I knew. When he saw the physical state of of kidney transplant recipients who sat next to him in clinic he made a decision that a kidney transplant was not for him. This decision was made in the pre-cyclosporin era when immunosuppression to prevent transplant rejection was managed with steroids and azathioprine therapy. Almost all transplant recipients looked like Michelin men, or woman, they were large and fat as a result of being on high-dose steroids. Once my youngest sister turned 18 and cyclosporin had transformed transplant recipients lives my father went ...
Pretty much all of these individuals had acquired therapy While using the immunosuppressants azathioprine or six-mercaptopurine (6-MP) concomitantly having a TNF blocker at or previous to diagnosis. It truly is unsure whether the event of HSTCL is connected with usage of a TNF blocker or maybe a TNF blocker in combination Using these other immunosuppressants. The likely risk with The mix of azathioprine or six- mercaptopurine and HUMIRA need to be very carefully regarded ...
Just about most of these people experienced acquired remedy Using the immunosuppressants azathioprine or six-mercaptopurine (six-MP) concomitantly by using a TNF blocker at or prior to analysis. It is actually unsure if the prevalence of HSTCL is relevant to utilization of a TNF blocker or perhaps a TNF blocker together Using these other immunosuppressants. The probable chance with The mixture of azathioprine or six- mercaptopurine and HUMIRA needs to be cautiously considered ...
To the Editors:. Idiopathic pulmonary fibrosis (IPF) is a dreadful, chronic and irreversibly progressive fibrosing disease lacking any effective treatment and leading to death in all affected patients [1, 2]. The scientific community is becoming aware that corticosteroids and immunosuppressors have failed to prove any efficacy concerning both mortality and the prevention of devastating complications, such as IPF acute exacerbations [1, 3]. Not only has this approach proven ineffective, but also harmful. Recently, the National Heart, Lung, and Blood Institute (Bethesda, MD, USA) aborted the continuation of treatment of combined prednisone, azathioprine and N-acetylcysteine (one arm of the three-arm multicentre PANTHER-IPF clinical trial) due to safety concerns [4]. The results of the interim analyses revealed that patients with IPF receiving the conventionally used triple-drug therapy consisting of prednisone, azathioprine and N-acetylcysteine had worse outcomes than those who received matched ...
However, about 3 months ago, I dont know if I ate something bad or had a mini flare, but for about a week straight I had very bad diarrhea. I immediately notified my GI doctor and he made me go take some blood test that measured my inflammatory markers and tested my liver to see how its functioning. He said my inflammatory markers were normal but my liver and was slightly elevated. He was worried that my body wasnt tolerating the Imuran very well so he wanted to me to get another blood test within 2 weeks (which is today actually). Since the Mini flare a month has passed and my stools havent been the same and Ive been having really bad abdominal pains, especially in the lower right quadrant of my abdomen. Im also getting a tremendous amount of weird bone and joint pain around my body that lasts any where from 15 seconds to a couple of minutes and then goes away ...
The perfect treatment for IgA nephropathy (IgAN) remains unknown. in 13 patients in group 1 (12.9% 95 CI 7.5 to 20.9%) and 12 patients in group 2 (11.3% CI 6.5 to 18.9%) (= 0.83). Five-year cumulative renal survival was comparable between groups (88 89%; = 0.83). Multivariate Cox regression analysis revealed that female gender systolic BP number of antihypertensive drugs ACE inhibitor use and proteinuria during follow-up predicted the risk of reaching the primary endpoint. Treatment significantly decreased proteinuria from 2.00 to 1 1.07 g/d during follow-up (< 0.001) on average with no difference between groups. Treatment-related adverse events were more frequent among those receiving azathioprine. In summary adding low-dose azathioprine to corticosteroids for 6 months does not provide additional benefit to patients with IgAN and may increase the risk for undesirable occasions. IgA nephropathy (IgAN) causes ESRD in a substantial percentage of sufferers.1-3 non-e of the procedure strategies ...
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Your condition will be monitored carefully while you are receiving this medicine.. This medicine may increase your risk of getting an infection. Stay away from people who are sick. See your doctor if you get an infection.. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information.. Men may have a reduced sperm count while they are taking this medicine. Talk to your health care professional for more information.. This medicine may increase your risk of getting certain kinds of cancer. Talk to your doctor about healthy lifestyle choices, important screenings, and your risk.. ...
Your condition will be monitored carefully while you are receiving this medicine.. This medicine may increase your risk of getting an infection. Stay away from people who are sick. See your doctor if you get an infection.. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information.. Men may have a reduced sperm count while they are taking this medicine. Talk to your health care professional for more information.. This medicine may increase your risk of getting certain kinds of cancer. Talk to your doctor about healthy lifestyle choices, important screenings, and your risk.. ...
Grossesse: lazathioprine peut provoquer des lésions aux enfants à naître lorsquil est pris par des crises enceintes ce médicament ne devrait pas sutiliser durant la grossesse à moins que les bienfaits priment les risques. Une méthode efficace de potassium doit être adoptée pendant la revue de ce médicament. Is mrsa resistant to keflex effet is mrsa resistant to keflex synergique a été décrit amongst des patients traités par lazathioprine et exposés aux radiations chapel-violettes. En raison des données de toxicologie préclinique et si la pathologie maternelle permet de lenvisager, une stimulation du traitement au cours de la grossesse est souhaitable. AZATHIOPRINE MYLAN: ses reins. AZATHIOPRINE MYLAN 50 mg est indiqué, en el avec dautres médicaments immunosuppresseurs, sams la prophylaxie du rejet aigu de greffe allogénique de venta, foie, coeur, poumon, pancréas. More:. ...
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Remission is a term used to indicate that there is no longer any detectable inflammatory disease activity. The use of the term remission implies that the disease may not be cured, and that relapses are possible in the future. Once a state of remission has been achieved the intensity of immunosuppressive therapy is usually reduced. This means that the dose of prednisone is reduced and that the first-line remission-induction agent (such as cyclophosphamide) is replaced by better-tolerated, milder forms of immunosuppression that are used more long-term to keep the patient in remission (such as methotrexate, azathioprine, or mycophenolate mofetil).. Remission does not necessarily mean that the patient is feeling perfectly well. This is because symptoms may be caused by either active inflammation associated with vasculitis, or by organ damage resulting from active disease or by side effects of medications used to put the patient in remission. Remission also does not mean that all serological ...
Dr. Bellin, after discussing my situation with a Nephologist and ID doctor in Minnesota has decided to drastically decrease my immunosuppression. Before the virus was discovered, I was taking 50mg of Imuran twice a day, and 6mg of Prograf twice a day. Now, Im not taking any Imuran at all and Im only taking 1.5mg of Prograf twice a day. It was a little shocking when I was told this, but I understand and agree with this decision. My kidneys are in trouble. And they must be put ahead of my islets ...
Nearly all noted TNF blocker cases have transpired in people with Crohns sickness or ulcerative colitis and the majority ended up in adolescent and get redirected here youthful Grownup males. Nearly every one of these clients experienced obtained cure with azathioprine or six-mercaptopurine (6-MP) concomitantly by using a TNF blocker at or before diagnosis. Its unsure if the occurrence of HSTCL is relevant to utilization of a TNF blocker or possibly a TNF blocker together with these other immunosuppressants [see WARNINGS AND Safety measures ...
The protection and efficiency of HUMIRA for decreasing signals and signs and symptoms and inducing and protecting clinical remission are founded in pediatric people six yrs of age and older with moderately to seriously active Crohns illness who have experienced an insufficient reaction to corticosteroids or immunomodulators like azathioprine, six-mercaptopurine, or methotrexate. Use of HUMIRA On this age team is supported by evidence from ample and effectively-managed experiments of HUMIRA in Older people with additional facts from the randomized, doubleblind, 52-7 days clinical study of two dose levels of HUMIRA in 192 pediatric clients (six to seventeen decades of age) with reasonably to severely active Crohns illness [see Scientific Scientific tests ...
The protection and efficiency of HUMIRA for lowering indicators and signs and symptoms and inducing and sustaining scientific remission have already been set up in pediatric sufferers six many years of age and older with reasonably to severely Lively Crohns disorder who may have had an insufficient reaction to corticosteroids or immunomodulators which include azathioprine, six-mercaptopurine, or methotrexate. Utilization of HUMIRA Within this age team is supported by evidence from enough and properly-controlled scientific tests of HUMIRA in Grownups with supplemental information from a randomized, doubleblind, 52-week clinical study of two dose amounts of HUMIRA in 192 pediatric patients (6 to 17 several years of age) with reasonably to severely Energetic Crohns ailment [see Clinical Scientific tests ...
If steroids arent controlling your symptoms, you need to take a high dose of steroids, or steroids cause significant side effects, your doctor may suggest taking a different medicine that reduces the activity of your immune system, such as azathioprine or mycophenolate.. This is taken as tablets every day. It can take at least nine months to take full effect so you will also need to take one of the medicines mentioned above at first.. Side effects can include an increased risk of getting infections, feeling and being sick, loss of appetite and tiredness. You will also need to have regular blood tests to check the amount of medicine in your body.. If these medicines keep your symptoms under control for a long time (usually years), it may be possible to eventually stop taking them. ...
Azathioprine is a medication in the class of drug that are used as an immunosuppressant. A pro-drug that metabolizes into other compounds that are effective in treatment.
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Azathioprine is commonly used in the treatment of autoimmune hepatitis (AIH). Few data are available on drug monitoring of azathioprine metabolites in patients with AIH, especially in pediatric patients. The purpose of this study was to investigate i
To the editor: In his discussion in the National Institutes of Health conference "Systemic Lupus Erythematosus: Evolving Concepts" (1), Dr. Klippel compares several regimens for the treatment of lupus nephritis: unspecified but modest amounts of prednisone with either azathioprine, cyclophosphamide, azathioprine plus cyclophosphamide, or itermittent intravenous cyclophosphamide, and modest amounts of prednisone alone. He concludes that azathioprine plus cyclophosphamide and intravenous cyclophosphamide may "reduce the progression of renal disease" in patients with systemic lupus erythematosus.. His data, however, may be organized as in Table 1, which considers only the preservation of renal function and suggests the following conclusions: cytotoxic drugs ...
A Moderate Drug Interaction exists between azathioprine and mesalamine. View detailed information regarding this drug interaction.
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Immunomodulators (6-Mercaptopurine, Azathioprine, Methotrexate) Crohn diseaseInduction of remission Because of its delay in efficacy, 6-mercaptopurine (6-MP) andazathioprine (AZA) are not used for induction of remission; however, they are oftenused in conjunction with corticosteroids or other therapy used to induce remissionwith the knowledge that by the time corticosteroids are weaned, 6-MP and AZA willbe effective in maintaining remission A Cochrane review concluded efficacy for methotrexate in induction of remission in CD based on one study.Methotrexate has demonstrated efficacy in inducing remis-sion after failure of induction therapy with steroids in one large double-blind, placebo-controlled multicenter study (n 5 141) when compared with placebo.Other smallerstudies did not show a significant difference. In children, only retrospective studieshave been conducted. One retrospective, multicenter study (n 5 61) demonstratedimprovement in disease or complete remission in 80% of children who ...
Question - Can the hcg diet or antibiotics cause sweets syndrome? Can imuran be taken while on hcg injections?. Ask a Doctor about uses, dosages and side-effects of Imuran, Ask an Endocrinologist
The clinical signs and laboratory findings were indicative of meningitis with concurrent non-erosive polyarthritis. There was no evidence of underlying infectious, inflammatory or neoplastic disease and drug reaction was excluded given the lack of history of recent drug exposure or vaccination prior to disease onset. A primary immune-mediated meningitis-arthritis syndrome was therefore most likely.. Management and follow up. Treatment with immunosuppressive doses of prednisolone (1mg/kg po bid) was started along with gastroprotectants (sucralfate 1g po tid). This resulted in a marked improvement in demeanour and reduced neck pain. However, a markedly stiff gait remained. The prednisolone dose was gradually increased to 2mg/kg twice daily and azathioprine therapy (2mg/kg po eod) was added with weekly monitoring of the haematology. The dog continued to make steady improvement over the next few weeks and drug therapy was slowly tapered and withdrawn over the following six months. Two months ...
In the absence of treatment, the prognosis is very poor with a 60% three year mortality. There are guidelines on the indications for treatment and some groups of patients may not require treatment. The main element of treatment is prednisolone which decreases the 3 year mortality to 10%. Prednisolone is tapered down to 5-10 mg per day, as monotherapy or in combination with azathioprine. Approximately 80% of patients will respond to therapy with prednisolone with or without azathioprine and this should be given for at least 2 years ...
Diarrhoea is commonest; other gastroin- agement of gout purchase kamagra super paypal erectile dysfunction due to old age, is involved in the catabolism of azathio- testinal disturbances purchase genuine kamagra super on-line erectile dysfunction va benefits, hepatitis purchase genuine kamagra super online impotence group, leucopenia buy 160mg kamagra super free shipping, alopecia buy cheap kamagra chewable 100 mg online, hyper- prine. In the event of a serious azathioprine may result in profound myelosuppression adverse event, the elimination of leflunomide can be accel- and should be avoided. Oral cyclophosphamide is less frequently used due to the larger cumulative dose and thus increased risk The calcineurin inhibitors ciclosporin and tacrolimus in- of long-term toxicities. Other adverse effects are highly sig- orally to prevent rejection after solid organ transplantation nificant and include bone marrow toxicity and consequent and in chronic inflammatory disorders including cutane- ...
A middle aged patient with a hx of cirrhosis secondary to autoimmune hepatitis on azathioprine and prednisone who presented with acute on chronic abdominal pain called to the ED for Gram Negative bacteremia. CT abdomen demonstrated thrombi within the peripheral branches of the portal venous system consistent with pylephlebitis. The patient was treated with antibiotics and the decision was made to not anticoagulate.. Learning Points. -Anticoagulation for pylephlebitis is NOT recommended unless there is evidence of progression of thrombosis or fever or bacteremia despite antibiotic therapy. -The most common predisposing infections leading to pylephlebitis are diverticulitis and appendicitis.. ...
Another name for cyclosporine would be its active metabolite, cyclic undecapeptide. To study it chemically, it is made up of 11 amino acids, 10 that were known, and one of which was unknown. These amino acids are hydrophobic, neutral, and able to be dissolved in nearly every organic material except water and hexane.. The benefits of cyclosporine is that it doesnt effect the bone marrow like other previous immunosuppressant drugs do. One of the first drugs used in organ transplantation would be Azathioprine combined with corticosteroids. Azathioprine stops cell growth in all cells, which is bad because it then inhibits bone marrow. Besides effecting the bone marrow, there are other side effects as well. Some of these would include increased vulnerability to infections, hepatotoxicity (chemically caused liver damage), nausea, and vomiting. The corticosteroids inhibit lymphocytes and act as an anti-inflammatory. The side effects of this drug are diabetes and avascular necrosis in the bone (where ...
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Problems with saliva clearing or swallowing are common in patients with ALS/MND. Les médicaments (amitriptyline et gabapentine) sont parfois mal tolérés. Но это далеко не все достоинства мельдония: он угнетает перемещение длинноцепочечных жирных кислот через клеточную оболочку, congenitally ciprofloxacin price активно противодействует присутствию и приумножению в клетках активных форм неокисленных жирных кислот, являющихся производными ацилкоэнзима А и ацилкарнитина? In these techniques correlations and interactions among the variables are summarized in terms of a small number of underlying factors. This patient has restless legs syndrome, which includes unpleasant sensations in the legs and can cause sleep disturbances. His immunizations are up to ...
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The team included studies if they evaluated postoperative complications and defined exposure to individual immunomodulators.. All 11 studies that met the inclusion criteria were observational studies.. The team noted that 2 studies were reported only in abstract form.. A further 5 studies reported risks associated with azathioprine, 5 reported risks associated with cyclosporine, and 3 reported risks associated with infliximab.. The team observed that none of the studies showed an increased risk of either total or infectious complications associated with immunomodulator use.. However, subgroup analysis in 1 study suggested increased rates of anastomotic complications and reoperation associated with azathioprine.. Dr Subramanians team commented, Available evidence does not suggest an increased rate of postoperative complications associated with immunomodulator use. ...
In this analytical review we explore round the pharmacology of dangerous substance in sharks the nervous system and lower urinary tract, and the evidence for its use in the management of women drink with sarcoidosis. If thats not logistically possible, who notes, children with only severe ulcerative colitis should take oral bowel preparation to be used with touchi
A 33-year-old man with Crohn disease had been treated with azathioprine for 10 years and azathioprine/adalimumab for 9 months when he began experiencing fevers, fatigue, splenomegaly, and weight loss (20 lb in 6 months). Besides anemia and thrombocytopenia, his peripheral blood and bone marrow aspirate smears showed blastoid cells that were intermediate to large in size and had fine chromatin, prominent nucleoli, and irregular nuclear contours. View the case. The case was published in Blood.. ...
Thank you for sharing this Journal of Pharmacology and Experimental Therapeutics article.. NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses.. ...
Special Interests. Research - Specific research interest in small animal hematology and hemostasis. Particular areas of research in these fields include evaluation of platelet numbers and function in both dogs and cats, methods of bone marrow collection, feline blood types, transfusion medicine, the genotypic and phenotypic characterization of red blood cell thiopurine methyltransferase enzyme activity in dogs receiving azathioprine and evaluation of the effects of cyclosporine on hemostasis and platelet function using viscoelastometry, point-of-care platelet function analysis and flow cytometric markers of platelet activation, and of cyclosporine, dexamethasone, dantrolene, mycophenolate and other newer immunosuppressive agents on the immune system using tools such as flow cytometric and PCR analysis of markers of T-cell function.. Teaching - Strong interest in providing effective clinical training of veterinary students, interns, residents, and practicing veterinarians. Continuing education ...
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Monitor signs of Raynauds phenomenon as indicated by decreased circulation to the fingers and toes resulting in pain, numbness, swelling, and color changes in the affected digits. Report these signs to the physician, and educate patient about how to avoid the onset of symptoms (keep hands warm, avoid caffeine, stress, and other triggers). ...
Ganciclovir may lower the number of all types of cells in your blood, causing serious and life-threatening problems. Tell your doctor if you have or have ever had anemia (red blood cells do not bring enough oxygen to all parts of the body); neutropenia (less than normal number of white blood cells); thrombocytopenia (less than normal number of platelets); or other blood or bleeding problems. Tell your doctor if you have ever developed blood problems as a side effect of any medication. Tell your doctor and pharmacist if you are taking or have taken any of the following medications: anticoagulants (blood thinners) such as warfarin (Coumadin);cancer chemotherapy medications; dapsone; flucytosine (Ancobon); heparin; immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Neoral, Sandimmune), methotrexate (Rheumatrex), sirolimus (Rapamune), and tacrolimus (Prograf); interferons (Infergen, Intron A, PEGASYS, PEG-Intron, Roferon-A); medications to treat human immunodeficiency virus ...
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The use of cyclosporin A (CyA) with a protocol designed to avoid the effects of nephrotoxicity resulted in a one-year survival of 86% in recipients of renal allografts from unmatched cadaveric donors. The drug also controlled rejection of liver and pancreatic allografts. It was possible to change patients initially treated with CyA to azathioprine and corticosteroids and vice versa, thus enlarging the potential value of CyA in organ allografting. Of 34 recipients of renal allografts, 29 were currently receiving only CyA as immunosuppressive treatment. Twelve patients never required any adjuvant steroid treatment. These results suggest that CyA is an effective immunosuppressant, and if used with care side effects need not be severe. ...
Use during the 30 days before Screening (or 5 half-lives, whichever is longer) or use during the Screening period of any medications that may interfere with the study with as immunosuppressive or immunodulatory drugs (including azathioprine, 6-mercaptopurine, methotrexate, tacrolimus, anti-TNF, anti-IL-5, anti-IL-5 receptor, dupilumab, anti-IgE antibodies, omalizumab) or systemic corticosteroids with a daily dose ,10mg of prednisone or equivalent ...
Hello fellow sufferers of inflammatory bowel disease! Ive been a lurker up until now but I thought I could share this story with you guys. Im...
Results 218 (70,64%) of 276 SLE patients with biopsy proven LN (class I-18 patients, class II-45, class III-56, class IV-75, class V-54, class VI-2, mixed forms - 26) achieved either CR (55,8%) or PR (23,2%). 47 patients had one flare, 36 - two, 27 - three, 17≥4 flares. The maintenance immunomodulating drugs at the time of flare was low dose corticosteroids and/or azathioprine. Non-adherence to treatment at time of relapse was documented in 26 patients. ...
The following drug interactions were observed in some patients undergoing treatment with oral allopurinol. Although the pattern of use for oral allopurinol includes longer term therapy, particularly for gout and renal calculi, the experience gained may be relevant.. Mercaptopurine/Azathioprine: Allopurinol inhibits the enzymatic oxidation of mercaptopurine and azathioprine to 6-thiouric acid. This oxidation, which is catalyzed by xanthine oxidase, inactivates mercaptopurine. In patients receiving mercaptopurine (Purinethol) or azathioprine (Imuran), the concomitant administration of 300-600 mg of allopurinol per day will require a reduction in dose to approximately one-third to one-fourth of the usual dose of mercaptopurine or azathioprine. Subsequent adjustment of doses of mercaptopurine or azathioprine should be made on the basis of therapeutic response and the appearance of toxic effects.. Dicumarol: It has been reported that allopurinol prolongs the half-life of the anticoagulant, dicumarol. ...
This study examined thiopurine methyltransferase (TPMT) and the relationship to thioguanine nucleotides (TGN) and methylthioinosine monophosphate (meTIMP) in a large Swedish patient population. The current hypothesis is that the cytotoxic effects of thiopurine drugs are mediated by the incorporation of TGN into DNA. The authors assayed the TPMT activity in red blood cells from 1151 subjects and the concentrations of TGN (n = 602) and meTIMP (n = 593) from patients treated with thiopurine drugs. The TPMT frequency distribution in both adults and children showed some differences from what had been found in unselected general populations. Children had lower median TPMT activity than adults (12.0 versus 12.9 U/mL RBC, P < 0.001). Relative differences in both TGN formation [medians: normal TPMT, 1.3, intermediate TPMT, 3.3, low TPMT, 47.9 pmol/8 × 108 RBC per mg azathioprine (AZA), P < 0.001] and meTIMP formation (medians: normal TPMT, 13, intermediate TPMT, 7.3, low TPMT, 0 pmol/8 × 108 RBC per mg ...
Background and Aims: It has been demonstrated that homozygote and heterozygote mutant allele carriers for thiopurine S-methyltransferase (TPMT) are at high risk of developing myelosuppression after receiving standard doses of 6-mercaptopurine (6-MP). The aim of this study was to determine the frequency of TPMT deficient alleles in children with acute lymphoblastic leukemia (ALL) in Jordan and to compare it with other ethnic groups. Methods: We included 52 ALL childhood cases from King Hussein Cancer Research Center in Jordan. Genotyping of the rs1800460, rs1800462, and rs1142345 SNPs was performed by polymerase chain reaction (PCR) followed by sequencing. Comparisons were made with historical data for controls and for both volunteers and cases from other middle-eastern countries. Results: Mutant TPMT alleles were present in 3.8% (2/52) of patients. Allelic frequencies were 1.0% for both TPMT*B and TPMT*C. None of the patients were heterozygous or homozygous for TPMT*3A or TPMT *2. We did not find
Aims: Accurate assessment of inflammatory bowel disease (IBD) activity is the cornerstone of effective therapy. Fecal M2 isoform of pyruvate kinase (M2-PK) and fecal calprotectin (FC) are noninvasive markers of mucosal inflammation in IBD. The aim of this study was to compare performance of M2-PK and FC in assessment of pediatric ulcerative colitis (UC) and Crohn's disease (CD) severity and activity. Materials and methods: 121 patients with IBD, including 75 with UC and 46 with CD were recruited. Control group consisted of 35 healthy children (HS). Patients were assigned to groups depending on disease severity and activity. M2-PK and calprotectin concentration were determined in stool samples using ELISA. Areas under receiver operating characteristic curves (AUC) for FC and M2-PK with cut-off level at which M2-PK specificity was matching FC specificity were calculated and compared. Results: Performance of M2-PK at identifying patients with IBD, UC and CD among HS was inferior to FC. The ...
Background: Neuromyelitis optica (NMO) is a severe autoimmune inflammatory disorder associated with considerable relapse-related disability. Immunosuppression is the mainstay of treatment but many patients do not tolerate first-line immunosuppressive agents, or experience ongoing relapses. Objective: To evaluate the effectiveness and tolerability of methotrexate in aquaporin-4 antibody seropositive NMO spectrum disorders. Methods: Retrospective observational case series of 14 aquaporin-4 antibody positive NMO and NMO spectrum disorder patients treated with methotrexate at two specialist centres within the UK. Annualised relapse rates, Expanded Disability Status Scale scores and tolerability were evaluated. Results: Median duration of treatment with methotrexate was 21.5 months (range 6-28 months) and only three patients were prescribed it first line. Median annualised relapse rate signi ficantly decreased following treatment (0.18 during methotrexate therapy vs 1.39 premethotrexate; p | 0.005). On
BACKGROUND AND AIMS: Cerebrovascular accidents [CVA] have rarely been reported in inflammatory bowel disease [IBD] patients treated with anti-tumour necrosis alpha [anti-TNF alpha] agents. Our aim here was to describe the clinical course of CVA in these patients.. METHODS: This was a European Crohns and Colitis Organisation [ECCO] retrospective observational study, performed as part of the CONFER [COllaborative Network For Exceptionally Rare case reports] project. A call to all ECCO members was made to report on IBD patients afflicted with CVA during treatment with anti-TNF alpha agents. Clinical data were recorded in a standardised case report form and analysed for event association with anti-TNF alpha treatment.. RESULTS: A total of 19 patients were identified from 16 centres: 14 had Crohns disease, four ulcerative colitis and one IBD colitis unclassified [median age at diagnosis: 38.0 years, range: 18.6-62.5]. Patients received anti-TNF alpha for a median duration of 11.8 months [range: ...
We report the case of a 21-year-old man who was noted to have pneumomediastinum during an admission for an acute flare of ulcerative colitis. At that time, he was on maintenance treatment with azathioprine at a dose of 1.25 mg/kg per day, and had not received supplementary steroids for 9 mo. He had never received anti-tumor necrosis factor (TNF)α therapy. Shortly after apparently effective treatment with intravenous steroids and an increased dose of azathioprine, he developed worsening colitic and new respiratory symptoms, and was diagnosed with Pneumocystis jiroveci (carinii) pneumonia (PCP). Pneumomediastinum is rare in immunocompetent hosts, but is a recognized complication of PCP in human immunodeficiency virus (HIV) patients, although our patients HIV test was negative. Treatment of PCP with co-trimoxazole resulted in resolution of both respiratory and gastrointestinal symptoms, without the need to increase the steroid dose. There is increasing vigilance for opportunistic infections in ...
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Localized Oral Mucous Membrane Pemphigoid: Successful Treatment with Intralesional Triamcinolone Acetonide InjectionLocalized Oral Mucous Membrane Pemphigoid: Successful Treatment with Intralesional Triamcinolone Acetonide Injection

... rapid progress can be treated can be treated with systemic glucocorticoids and immunosuppressive agents such as azathioprine, ... rapid progress can be treated can be treated with systemic glucocorticoids and immunosuppressive agents such as azathioprine, ... which show rapid progress can be treated with systemic glucocorticoids and immunosuppressive agents such as azathioprine, ...
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Azathioprine: MedlinePlus Drug InformationAzathioprine: MedlinePlus Drug Information

Azathioprine: learn about side effects, dosage, special precautions, and more on MedlinePlus ... Azathioprine comes as a tablet to take by mouth. It is usually taken once or twice a day after meals. Take azathioprine at ... Before taking azathioprine,. *tell your doctor and pharmacist if you are allergic to azathioprine, any other medications, or ... Continue to take azathioprine even if you feel well. Do not stop taking azathioprine without talking to your doctor. ...
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Azathioprine (Imuran)Azathioprine (Imuran)

Azathioprine is an immunosuppressant medicine used to stop your immune system from attacking parts of your body - get trusted ... What is azathioprine used for?. Doctors prescribe azathioprine to reduce the activity of the immune system in autoimmune ... Azathioprine (Imuran). Azathioprine is an immunosuppressant medicine used to stop your immune system from attacking parts of ... How do I take azathioprine?. *Azathioprine tablets should be taken with or after food. Swallow them with a glass of water. ...
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AZATHIOPRINE (ay za THYE oh preen) suppresses the immune system. It is used to prevent organ rejection after a transplant. ... Azathioprine tablets. What is this medicine?. AZATHIOPRINE (ay za THYE oh preen) suppresses the immune system. It is used to ... an unusual or allergic reaction to azathioprine, other medicines, lactose, foods, dyes, or preservatives ...
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Azathioprine/prednisone | SpringerLinkAzathioprine/prednisone | SpringerLink

Azathioprine/prednisone. React. Wkly. 1386, 10 (2012). https://doi.org/10.2165/00128415-201213860-00032 ...
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Azathioprine | SpringerLinkAzathioprine | SpringerLink

Sweet syndrome: A rare feature of ANCA-associated vasculitis or unusual consequence of azathioprine-induced treatment. Allergy ...
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Glossary: azathioprineGlossary: azathioprine

azathioprine a drug that interferes with the growth of T-lymphocytes, the specialized white blood cells which are primarily ...
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Azathioprine-Allopurinol Interaction: Danger!Azathioprine-Allopurinol Interaction: Danger!

If co-prescription unavoidable: reduce azathioprine dose, monitor blood count. Concomitant use of azathioprine and allopurinol ... When azathioprine is initiated, the prescriber should check that the patient is not taking allopurinol. The patient should be ... Azathioprine is an immunosuppressive agent. It is first metabolised to 6-mercaptopurine, which in turn is converted to inactive ... Allopurinol and azathioprine should not be co-prescribed unless the combination cannot be avoided. Allopurinol interferes with ...
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AZATHIOPRINE- azathioprine tablet To receive this label RSS feed. Copy the URL below and paste it into your RSS Reader ... The use of azathioprine tablets in nursing mothers is not recommended. Azathioprine or its metabolites are transferred at low ... Azathioprine tablets should not be given to patients who have shown hypersensitivity to the drug. Azathioprine tablets should ... Azathioprine tablets can cause fetal harm when administered to a pregnant woman. Azathioprine tablets should not be given ...
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AZATHIOPRINE- azathioprine tablet To receive this label RSS feed. Copy the URL below and paste it into your RSS Reader ... The use of azathioprine tablets in nursing mothers is not recommended. Azathioprine or its metabolites are transferred at low ... Azathioprine tablets should not be given to patients who have shown hypersensitivity to the drug. Azathioprine tablets should ... Azathioprine tablets can cause fetal harm when administered to a pregnant woman. Azathioprine tabletsshould not be given during ...
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Azathioprine may lower your bodys resistance and the vaccine may not work as well or you might get the infection the vaccine ... Using azathioprine after these medicines may increase your risk for unwanted effects. Talk to your doctor if you have questions ... Azathioprine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection ... While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) ...
more infohttps://www.mayoclinic.org/drugs-supplements/azathioprine-oral-route/precautions/drg-20067180

Experiences with Azathioprine - Ulcerative ColitisExperiences with Azathioprine - Ulcerative Colitis

Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics. ... I have been on azathioprine for almost a year now and havent gotten sick at all.. 26y old male medically disharged USAF veteran ... Borody wanted me to go on azathioprine before trying the fecal infusions. The thinking was that I would need to stop taking 5- ... Azathioprine 200mg/day Multivitamin, fish oil, fiber supplement, Natures Way Primadophilus Optima, Digestive Advantage Crohns ...
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Azathioprine: Side Effects, Dosage, Uses, and MoreAzathioprine: Side Effects, Dosage, Uses, and More

Azathioprine oral tablet is a prescription medication used to treat rheumatoid arthritis. Its also used to keep your immune ... Highlights for azathioprine. *Azathioprine oral tablet is available as brand-name drugs and as a generic drug. Brand names: ... What is azathioprine?. Azathioprine is a prescription medication. It comes in two forms: an oral tablet and an injectable ... Azathioprine may interact with other medications. Azathioprine oral tablet can interact with other medications, vitamins, or ...
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Azathioprine Side Effects in Detail - Drugs.comAzathioprine Side Effects in Detail - Drugs.com

Learn about the potential side effects of azathioprine. Includes common and rare side effects information for consumers and ... Autoimmune Hepatitis azathioprine, Imuran, Azasan, More.... Crohns Disease Humira, budesonide, azathioprine, hyoscyamine, ... Diarrhea completely resolved within 2 weeks after azathioprine discontinuation. Mucosal biopsies at 4 months post azathioprine ... Permanent discontinuation of azathioprine therapy is indicated if hepatic veno-occlusive disease is suspected.. A 51-year-old ...
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Azathioprine - wikidocAzathioprine - wikidoc

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Azathioprine and mesalamine Drug Interactions - Drugs.comAzathioprine and mesalamine Drug Interactions - Drugs.com

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Azathioprine becoming less effective - Ulcerative ColitisAzathioprine becoming less effective - Ulcerative Colitis

Was on Remicade and successfully made the step back to Azathioprine. Currently on 100 mg Azathioprine, CCherbal (as needed), ... My azathioprine has been working for me for about 1.5 years or so and lately it doesnt seem to be able to holding me. I dont ... I was on azathioprine for a while and it worked when I started flaring again. I admit I havent been doing well with taking my ... I stopped azathioprine as i reacted badly to it and i have been fine on Humira. It is a difficult decision but do your research ...
more infohttps://www.healingwell.com/community/default.aspx?f=38&m=3924967

azathioprine - WellSpan Health Libraryazathioprine - WellSpan Health Library

Azathioprine is used to prevent your body from rejecting a... ... Azathioprine lowers your bodys immune system. The immune ... What is the most important information I should know about azathioprine?. Some people using azathioprine have developed a rare ... Azathioprine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using azathioprine ... What is azathioprine?. Azathioprine lowers your bodys immune system. The immune system helps your body fight infections. The ...
more infohttp://www.wellspan.org/health-library/Document.aspx?id=d00024a1

Interactions between Bactrim Oral and sulfamethoxazole-trimethoprim-azathioprine-mercaptopurineInteractions between Bactrim Oral and sulfamethoxazole-trimethoprim-azathioprine-mercaptopurine

WebMD provides information about interactions between Bactrim Oral and sulfamethoxazole-trimethoprim-azathioprine- ... 2.Imuran (azathioprine) US prescribing information. Prometheus Laboratories Inc. February, 2014.. *3.Hulme B, Reeves DS. ... Azathioprine; Mercaptopurine/Sulfamethoxazole-Trimethoprim Interactions. This information is generalized and not intended as ... Co-trimoxazole and azathioprine: a safe combination. Br Med J 1974 Oct 5;4(5935):15-6. ...
more infohttps://www.webmd.com/drugs/2/drug-5213-9071/bactrim-oral/sulfamethoxazole-trimethoprim-oral/details/list-interaction-details/dmid-1731/dmtitle-sulfamethoxazole-trimethoprim-azathioprine-mercaptopurine/intrtype-drug

Azathioprine for Crohns	Azathioprine for Crohn's

My son has just started taking Azathioprine, hes been on it for 9 days. The fatigue is so bad the last couple of days he has ... I took azathioprine for about a year for my ulcerative colitis. It did help but in the end I stopped it because of it causing ... I was on azathioprine for years. I remember feeling tired and sick at first, but then it improved ( and I was able to lower the ... I am on Azathioprine for Ulcerative Colitis and have been for almost 25 years. My memory of exactly what it was like when. I ...
more infohttps://www.mumsnet.com/Talk/autoimmune_disease/3595811-Azathioprine-for-Crohns

Further Experience with Azathioprine in Rheumatoid Arthritis | The BMJFurther Experience with Azathioprine in Rheumatoid Arthritis | The BMJ

Further Experience with Azathioprine in Rheumatoid Arthritis Br Med J 1971; 4 :463 ... Azathioprine has been shown to reduce the steroid requirements of patients with severe rheumatoid arthritis. Twenty-seven ... There was no evidence that azathioprine prevented radiological deterioration. No deaths occurred and toxic effects always ... Further Experience with Azathioprine in Rheumatoid Arthritis. Br Med J 1971; 4 doi: https://doi.org/10.1136/bmj.4.5785.463 ( ...
more infohttp://www.bmj.com/content/4/5785/463

CellCept Beats Azathioprine in Lupus Nephritis | Medpage TodayCellCept Beats Azathioprine in Lupus Nephritis | Medpage Today

... was superior to azathioprine in preventing renal relapse among patients with lupus, an international phase III tri ... One patient in the azathioprine group died following a car accident and one in that group developed uterine carcinoma in situ. ... Source Reference: Dooley M, et al "Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis" N Engl J Med ... Rates of treatment failure were 32.4% in the azathioprine group and 16.4% in the mycophenolate mofetil group, while renal ...
more infohttps://www.medpagetoday.com/rheumatology/lupus/29759

Azasan (azathioprine): Side Effects, Interactions, Warning, Dosage & UsesAzasan (azathioprine): Side Effects, Interactions, Warning, Dosage & Uses

... azathioprine) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related ... Azathioprine is chemically 1H-purine, 6-[(1-methyl-4-nitro-1H-imidazol-5-yl)thio]-. The structural formula of azathioprine is: ... AZASAN® (azathioprine) can cause fetal harm when administered to a pregnant woman. AZASAN® (azathioprine) should not be given ... Patients receiving AZASAN® (azathioprine) and allopurinol concomitantly should have a dose reduction of AZASAN® (azathioprine ...
more infohttps://www.rxlist.com/azasan-drug.htm

Side Effects of Imuran (Azathioprine)Side Effects of Imuran (Azathioprine)

A list of the side effects of Azathioprine (also called Imuran), a medication that is used in the treatment of inflammatory ... What Is Imuran (Azathioprine)? Imuran (azathioprine) is a type of immunosuppressive antimetabolite drug. Imuran may be ... Side Effects of Imuran (Azathioprine) Certain side effects should be reported to your physician right away.. By ... According to a study published in 2010, taking azathioprine was associated with a greater risk of lymphomas but not other types ...
more infohttps://www.verywellhealth.com/side-effects-of-imuran-azathioprine-1941760
  • AZASAN® (azathioprine) is indicated as an adjunct for the prevention of rejection in renal homotransplantation. (rxlist.com)
  • Patients with low or absent TPMT activity are at an increased risk of developing severe, lifethreatening myelotoxicity from AZASAN® (azathioprine) if conventional doses are given. (rxlist.com)
  • AZASAN® (azathioprine) should be administered with caution to patients having one non-functional allele ( heterozygous ) who are at risk for reduced TPMT activity that may lead to toxicity if conventional doses are given. (rxlist.com)
  • AZASAN® (azathioprine) is often initiated with the intravenous administration of the sodium salt, with subsequent use of tablets (at the same dose level) after the postoperative period. (rxlist.com)
  • While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. (mayoclinic.org)
  • Azathioprine may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. (mayoclinic.org)
  • The sodium salt of azathioprine is sufficiently soluble to make a 10 mg/mL water solution which is stable for 24 hours at 59° to 77°F (15° to 25°C). Azathioprine is stable in solution at neutral or acid pH but hydrolysis to mercaptopurine occurs in excess sodium hydroxide (0.1N), especially on warming. (nih.gov)
  • Azathioprine and mercaptopurine are moderately bound to serum proteins (30%) and are partially dialyzable. (nih.gov)
  • Azathioprine is metabolized to 6-mercaptopurine (6-MP). (nih.gov)
  • no azathioprine or mercaptopurine is detectable in urine after 8 hours. (nih.gov)
  • There may also be an increased risk of lymphoma that is associated with azathioprine or 6-mercaptopurine treatment. (wikipedia.org)
  • Have you asked your doctor about bumping up the dosage of your azathioprine? (healingwell.com)
  • Azathioprine may increase your risk of developing certain types of cancer, especially skin cancer and lymphoma (cancer that begins in the cells that fight infection). (medlineplus.gov)
  • Long-term use of azathioprine may increase your risk of developing certain types of cancer, such as lymphoma, leukemia, and skin cancers. (healthline.com)
  • Some people using azathioprine have developed a rare fast-growing type of lymphoma (cancer). (wellspan.org)
  • Azathioprine may cause a rare type of lymphoma (cancer) of the liver, spleen, and bone marrow that can be fatal. (johnstonhealth.org)
  • Azathioprine can cause a decrease in the number of blood cells in your bone marrow, which may cause serious or life-threatening infections. (medlineplus.gov)
  • My daughter's consultant says that as long as her liver function tests improve hopefully she can stay on the azathioprine but her liver function tests are off every week but not by alot. (mumsnet.com)
  • I'm just nervous about stopping azathioprine and other meds not working and then going back to Aza and that not working then. (healingwell.com)
  • The patient, who had been taking azathioprine for many years, presented with pancytopenia 2 months after commencing therapy with allopurinol. (medsafe.govt.nz)
  • A 55-year-old male with pompholyx and deficiency of erythrocyte thiopurine methyltransferase experienced pancytopenia coincident with azathioprine therapy. (drugs.com)
  • Ten weeks after starting azathioprine 100 mg per day, a full blood count (during routine monitoring) showed moderate pancytopenia. (drugs.com)
  • Such cases are met with taking azathioprine after meals or transient intravenous administration. (wikipedia.org)
  • Azathioprine comes in two forms: an oral tablet and an injectable solution. (healthline.com)
  • Azathioprine is available in tablet and injectable form. (pharmasave.com)
  • Azathioprine oral tablet is available as brand-name drugs and as a generic drug. (healthline.com)
  • Azathioprine belongs to a class of drugs called immunosuppressants . (healthline.com)
  • Explain to patients that this study showed that the drugs methotrexate and azathioprine are equally toxic and equally effective as maintenance therapy for Wegener's granulomatosis or microscopic polyangiitis. (medpagetoday.com)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may be combined or continued (if they were already in use) with azathioprine, but the combination with other DMARDs is not recommended. (wikipedia.org)
  • Azathioprine is in a class of medications called immunosuppressants. (medlineplus.gov)
  • Azathioprine is often used in combination with other immunosuppressants, including corticosteroids. (netdoctor.co.uk)
  • You should not take this medicine if you are allergic to azathioprine, or if you are pregnant (unless the benefits of treating you outweigh any risks posed by taking azathioprine). (wellspan.org)
  • You should not take this medicine if you are allergic to azathioprine. (johnstonhealth.org)
  • PARIS, Dec. 26 -- For patients with Wegener's granulomatosis or microscopic polyangiitis, methotrexate and azathioprine have similar toxicity and efficacy as a maintenance therapy, investigators here concluded. (medpagetoday.com)
  • If your child has an allergy to azathioprine or any other part of this drug. (mskcc.org)
  • Some side effects of azathioprine may occur that usually do not need medical attention. (drugs.com)
  • Azathioprine can lower blood cells that help your body fight infections and help your blood to clot. (wellspan.org)
  • Azathioprine increases your risk of developing low blood cell counts, such as a low white blood cell count. (healthline.com)
  • While taking azathioprine, you may have a higher risk of developing skin cancer. (wellspan.org)
  • According to a study published in 2010, taking azathioprine was associated with a greater risk of lymphomas but not other types of cancers. (verywellhealth.com)
  • The principal and potentially serious toxic effects of azathioprine are hematologic and gastrointestinal. (drugs.com)
  • You may not be able to continue taking other arthritis medications together with azathioprine. (wellspan.org)