Frequency of thiopurine methyltransferase mutation in patients of Mediterranean area with inflammatory bowel disease and autoimmune disorders

Dig Liver Dis. 2016 Dec;48(12):1506-1509. doi: 10.1016/j.dld.2016.08.125. Epub 2016 Sep 1.

Abstract

Background and aims: Few studies exist on the frequency of thiopurine methyltransferase (TPMT) mutation in patients from Southern Europe. We aimed to evaluate the frequency of TPMT mutation in a homogeneous Sicilian cohort of patients with inflammatory bowel disease (IBD), autoimmune and hematological disorders, the rate of thiopurine-related adverse events, and its association with the TPMT genotype.

Results: Among 105 patients with IBD, 45 with autoimmune disease, and 34 with hematologic diseases, the homozygous TPMT variant genotype was found in one patient only (0.5%), while the heterozygous TPMT genotype was identified in 8 patients (4.3%). In patients with IBD, leukopenia was observed in ten patients: one had the homozygous TPMT genotype, one the heterozygous genotype, and the remaining eight the wild type genotype.

Conclusions: The frequency of TPMT mutation in a Mediterranean area was low. TPMT genotyping is not a sensitive tool for predicting thiopurine-induced leukopenia.

Keywords: 6-Mercaptopurine; Adverse events; Azathioprine; Genetics.

MeSH terms

  • Adult
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / genetics*
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use
  • Female
  • Hematologic Diseases / genetics*
  • Heterozygote
  • Homozygote
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / genetics*
  • Italy
  • Leukopenia / chemically induced
  • Male
  • Mercaptopurine / adverse effects
  • Mercaptopurine / therapeutic use
  • Methyltransferases / genetics*
  • Middle Aged
  • Mutation
  • Phenotype
  • Polymorphism, Genetic

Substances

  • Immunosuppressive Agents
  • Mercaptopurine
  • Methyltransferases
  • thiopurine methyltransferase
  • Azathioprine