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Mediators of Inflammation
Volume 7, Issue 3, Pages 141-144
http://dx.doi.org/10.1080/09629359891045

Azathioprine in inflammatory bowel disease, a safe alternative?

Department of Gastroenterology and Hepatology, Internal Medicine II, Erasmus University Hospital-Dijkzigt, Dr. Molewaterplein 40, Rotterdam 3015 GD, The Netherlands

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Azathioprine and its metabolite 6-mercaptopurine are effective in the treatment of inflammatory bowel disease. They are mostly used for reduction of the use of steroids, maintenance therapy after remission induction by cyclosporin and treatment of fistulae in Crohn's disease. Adverse effects occur in about 15% of patients. The main side effects are pancreatitis, allergic reactions, fever and bone marrow suppression. Symptoms, management and prevention are discussed. A blood monitoring schedule is suggested. Azathioprine and 6-mercaptopurine seem to be safe in pregnancy. There may be a slight increased risk for developing a non-Hodgkin's lymphoma.