, Volume 1440, Issue 1, p 24
Date: 23 Feb 2013

Mercaptopurine

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An event is serious (FDA MedWatch definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * requires intervention to prevent permanent impairment or damage

  • An 8-year-old girl with acute lymphoblastic leukaemia had an inappropriate growth hormone response to hypoglycaemia, while receiving oral mercaptopurine [dose not stated].

    The girl developed intermittent morning shakiness, nausea and vomiting 27 weeks before the end of her maintenance therapy which included nightly mercaptopurine. She drank orange juice and her symptoms resolved. Laboratory test results included the presence of urine ketones, lack of response to glucagon, and low insulin-like growth factor (IGF)-1 and IGF binding protein-3 levels. She unexpectedly did not experience an increase in growth hormone levels.

    The girl's mercaptopurine dose was then given in the morning instead of nightly. Her symptoms improved, but recurred 6 weeks before therapy com ...