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To test the effectiveness of 6-mercaptopurine (6-MP) in the treatment of Crohn's disease, we entered 83 chronically ill patients into a two-year double-blind study comparing 6-MP with placebo. Crossover data showed that improvement occurred in 26 of 39 courses of 6-MP (67%) as compared with three of 39 courses of placebo (8%) (P less than 0.001).(More)
We assess toxicity related to 6-mercaptopurine in the treatment of inflammatory bowel disease by reporting our experience with 396 patients (120 patients with ulcerative colitis, 276 with Crohn disease) observed over 18 years. Follow-up data for a mean period of 60.3 months were obtained for 90% of the patients. Toxicity directly induced by 6-mercaptopurine(More)
OBJECTIVE The aim of this study was to determine whether a relationship exists between the use of nonsteroidal antiinflammatory drugs (NSAIDs) and exacerbation or onset of inflammatory bowel disease (IBD). METHODS Sixty consecutive IBD patients admitted to the hospital were carefully interviewed to ascertain whether they used NSAIDs and the relationship(More)
Rectal biopsies of sigmoidoscopically normal mucosa from 99 patients with Crohn's disease of the ileum, colon, or both were studied histologically, with particular reference to the presence of granulomas. Among the 14 cases of granulomas, some were of the usual sarcoid type and could easily be detected. Other microgranulomas were less well defined and were(More)
We report our observations over 18 years (1970-1988) on 81 compliant patients with resistant ulcerative colitis who received 91 courses of treatment with 6-mercaptopurine (6-MP) for at least 4 months. These represent 172 patient years of 6-MP therapy and 308 years of observation after initiating 6-MP. In all patients, treatment with sulfasalazine and(More)
Of 99 patients with Crohn's disease whose rectal segment appeared normal on sigmoidoscopy, there was histologic inflammation in 45% and features characteristic of Crohn's disease in 30% of rectal biopsy specimens. Granulomas were found in 18% of patients, including 13% of those with ileitis, 13% of those with ileocolitis, and 37% of those with colitis.(More)
OBJECTIVE The outcomes of pregnancies after maternal use of 6-mercaptopurine (6-MP) for inflammatory bowel disease (IBD) during pregnancy have been reported, but data are lacking for outcomes when the fathers use this drug. METHODS Subjects were male patients with IBD seen at one center between 1970 and 1997. Patients and their wives were interviewed.(More)
OBJECTIVE 6-Mercaptopurine (6MP) and azathioprine are immunomodulators used in the treatment of refractory Crohn's disease. Studies have confirmed their efficacy and value in maintenance of remission, but it is our purpose to determine how long 6MP/azathioprine should be continued once remission has been accomplished. METHODS Careful follow-up was(More)
BACKGROUND Crohn's disease (CD) has the highest prevalence among individuals of Ashkenazi Jewish (AJ) descent compared to non-Jewish Caucasian populations (NJ). We evaluated a set of well-established CD-susceptibility variants to determine if they can explain the increased CD risk in the AJ population. METHODS We recruited 369 AJ CD patients and 503 AJ(More)
Diverting the fecal stream has been considered to affect the course of Crohn's disease favorably. Adverse effects on the distal segment have not previously been distinguished from clinical signs and symptoms. The course of four patients with Crohn's disease who underwent fecal diversion with an in situ rectum were observed in whom sigmoidoscopy was(More)