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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Case Report

The Effect of Renal Replacement Therapy in a Patient with Mercaptopurine Toxicity: Time to Revise Guidelines

Author(s): H.J.L. Quaedvlieg*, F.N. Polderman, M. Borkent, De H.J.M. Jonge, P.A. Annema, L.J.J. Derijks, M.A. Sikma and C. Bethlehem

Volume 19, Issue 2, 2024

Published on: 03 August, 2023

Page: [299 - 302] Pages: 4

DOI: 10.2174/1574886318666230714105801

Price: $65

Abstract

Introduction: Mercaptopurine, a thiopurine, is used in various disorders of immune regulation, such as autoimmune hepatitis. Thiopurine metabolism is complex with risk for overdosing, especially when metabolism is impaired by liver dysfunction. Hepatotoxicity may be due to mercaptopurine overdose and is often reversible after prompt cessation of the drug.

Case Presentation: Treatment of thiopurine toxicity is mainly supportive and literature on enhanced elimination by renal replacement therapy is ambiguous.

Conclusion: In this case of thiopurine toxicity, a patient with autoimmune hepatitis presents with abdominal pain, nausea, vomiting, and diarrhea. We show in this case report that renal replacement therapy had no effect on total body clearance of mercaptopurine.

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