Imuran and infection?

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Date Joined Mar 2007
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   Posted 2/11/2010 7:45 PM (GMT -7)   
Does anyone know how much more likely the risk of infection is, at the kind of dosages of Imuran Crohn's patients take? (100mgs)
More specifically, my daughter recently obtained a nasty cut from a skate blade on the inside of her thigh. It's just short of needing stitches. We're taking pretty good care of it, but I'm concerned about infection, or slower healing. 
Like many of the side effects to immunosupressants, they seem to be of more concern at the exteme dosages taken for other medical issues. 
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.

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   Posted 2/11/2010 9:24 PM (GMT -7)   
In the 6 years I have been taking Imuran, I have had maybe 4 infections requiring antibiotics. However, none of these were for infections caused by breaks or cuts in the skin. I am an active gardener and cook and have had my share of cuts caused by broken sticks or improper knife handling. Some have been pretty deep puncture wounds. I just keep the site clean and dressed and watch for signs of infection like any person should/would do.

I don't have statistics for you to detail infection risk while on low dose Imuran. And yes, 100 mg is considered low dose compared to what transplant individuals take. I will say that my GI and rheumy both told me that my immune system is OVERactive and that taking Imuran makes mine more like that of individuals without autoimmune disease. Not sure if this is true but I do think there is some validity to it. I have far FEWER infections since being on Imuran than I did prior. I used to routinely get infections on my fingers from breaks in the cuticles before I went on Imuran. That no longer happens. Perhaps it is coincidence.

You seem to be treating her cut appropriately. Just watch for signs of infection and if any occur, get her seen. Hope she has no scarring!
Moderator Crohn's Disease  & Osteoarthritis Forums
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, asthma, severe allergy and a host of other medical problems.

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Date Joined Apr 2006
Total Posts : 1885
   Posted 2/11/2010 9:48 PM (GMT -7)   
The dose of Imuran for a transplant in a person weighing 120 lbs would range from a low of 164 mg to a high of 273 mg.

Renal Homotransplantation: The dose of IMURAN required to prevent rejection and minimize toxicity will vary with individual patients; this necessitates careful management. The initial dose is usually 3 to 5 mg/kg daily, beginning at the time of transplant. IMURAN is usually given as a single daily dose on the day of, and in a minority of cases 1 to 3 days before, transplantation.

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Date Joined Mar 2007
Total Posts : 1775
   Posted 2/12/2010 4:03 AM (GMT -7)   
Thanks Ides,
I appreciate the reassurance. We'll definitely keep an eye.
I would have thought the dosages for something like transplant recipeints would be considerably higher.
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.

ski bum
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Date Joined Jan 2007
Total Posts : 451
   Posted 2/12/2010 5:09 AM (GMT -7)   
Just sharing something a nephrologist told me - they don't use Imuran anymore for transplant patients anymore. He told me they have better drugs now.
50 y/o F. CD dx'd Aug 05. Initially on Pentasa, then Imuran 125 mg. Started Humira (very reluctantly) on 10/24/07. Ileocolectomy 4/08. Back on Pentasa as maintenance.

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Date Joined Apr 2005
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   Posted 2/12/2010 5:30 AM (GMT -7)   
When I get a cut, even a scratch from one of my cats, it doesn't heal as quickly as a non-CDer. But its my prednisone that causes the delay in heal time. When I have had surgery, they have waited an extra few days each time before taking out the staples. But I have not gotten infections from my cuts.

CD 20 years officially, 30 unofficially. 3 resections '93, '95 '97
Managing with strict low residue diet, keeping symptoms to a minimum. All test show small amount of ulceration, still have occasional blockages. But still have a great time with my 2 daughters and husband!

Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....

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