Reactions 1704, p237 - 2 Jun 2018 Hepatotoxicity, aching limbs and exercise intolerance: 2 case reports In a case series, a 21-month-old boy and a 10-year-old girl were described, of whom, the boy developed aching limbs and exercise intolerance while the girl developed hepatic toxicity following treatment with mercaptopurine [6-Mercaptopurine] [routes not stated, not all dosages and durations of treatments to reactions onsets stated]. Patient 2: The boy, who had acute lymphoblastic leukaemia, received mercaptopurine. His dose was gradually increased but at higher doses, he developed symptoms of aching limbs and exercise intolerance. Consequently, he was switched to tioguanine [6-thioguanine] and his muscular symptoms resolved. Patient 3 : The girl, who had acute lymphoblastic leukaemia, received mercaptopurine. Subsequently, she developed recurrent episodes of conjugated hyperbilirubinaemia after one month of initiating mercaptopurine therapy. Four months later, she was hospitalised due to deranged coagulation, hypoglycaemia and hepatic encephalopathy. A liver biopsy revealed hepatocyte ballooning and moderate cholestasis. These findings were consistent with mercaptopurine induced hepatotoxicity. Thereafter, the girl received supportive management and her liver function recovered. Her mercaptopurine therapy was switched to tioguanine [6-thioguinine]. Author comment: "During maintenance 6MP metabolites were persistently subtherapeutic but [Mercaptopurine] dose escalation was limited by symptoms of aching limbs and exercise intolerance on higher doses. Liver biopsy demonstrated hepatocyte ballooning and moderate cholestasis, consistent with [Mercaptopurine] toxicity." Samuelson C, et al. When should we consider 6-thioguanine instead of 6-mercaptopurine in treating childhood acute lymphoblastic leukaemia? A case series and review of the literature. British Journal of Haematology 181 (Suppl. 1): 189-190 (plus poster) abstr. BSH18-EP-061, Apr 2018. Available from: URL: http://doi.org/10.1111/bjh.15226 [abstract] - United Kingdom 803323276 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera