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Multiple Sclerosis
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Azathioprine myelosuppression in multiple sclerosis: characterizing thiopurine methyltransferase polymorphisms

E M Frohman

Department of Neurology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA, Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA, elliot.frohman{at}utsouthwestern.edu

E Havrdova

Department of Neurology, Charles University, Prague, Czech Republic

B Levinson

Department of Hematology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

O Slanar

Department of Clinical Pharmacology, Charles University, Prague, Czech Republic

We describe two multiple sclerosis patients who developed pancytopenia following treatment with azathioprine. They were found to have the homozygous polymorphism for thiopurine methyltransferase deficiency and recovered after cessation of drug therapy. We review the literature concerning this molecular derangement and underscore the importance of performing surveillance testing for allelic characterization prior to treatment intervention with this agent for immune-mediated disorders.

Key Words: azathioprine • polymorphism • thiopurine methytransferase

Multiple Sclerosis, Vol. 12, No. 1, 108-111 (2006)
DOI: 10.1191/135248506ms1249cr
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