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04-04-2013, 02:24 PM   #1
Carlino
 
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6-TGN Level

Hi everyone--this is my first post ever here.

My doctor just called with same lab results and i'm trying to figure out what everything means. Google has soo much information that it's overwhelming.

Currently I take:

100mg Imuran
5mg Prednisone (tapering myself off because I've been on since July '11)
4800mg Asacol HD

She said my 6-TGN Level is 150 and some other level is 5000.

Can anyone help?
04-04-2013, 02:59 PM   #2
Johnnysmom
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6 TGN - 235-450 correlate with remission. Levels greater than 450 can lead to myelosuppression.

The other level is probably 6-MMP below 5700 pmol- liver problems. (This is what I wrote in my notes but I think it means you want to be below 5700).

My son's TGN was 130 last time so they doubled his dosage. My guess is from your numbers they might up your dose of Imuran. But my son takes 6mp so not sure if it is apples to apples.

Hope that helps a little.
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04-04-2013, 03:02 PM   #3
Johnnysmom
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Sorry, should have explained- the 6 TGN measures the amount of Imuran in your system. The goal is to be in the therapeutic range. Too high and your body doesn't have enough White blood cells to fight off infection. Too low and the drug is not effective.

The 6-mmp just measures the effect the drug is having on your liver.
04-04-2013, 03:36 PM   #4
Carlino
 
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This actually helps so much. So my doctor said that my labs look good--we're just going to watch the 6-TGN level...so from what i've gathered, they might want to up my dose a bit. I guess I'll wait it out. I've only been on 100mg for about a month now.

thank you!
04-04-2013, 11:27 PM   #5
2thFairy
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Welcome to the forum, Carlino!
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04-04-2013, 11:40 PM   #6
rollinstone
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Who needs med school when we have crohn's forum
04-05-2013, 05:20 AM   #7
2thFairy
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Who needs med school when we have crohn's forum
No doubt!
04-05-2013, 07:57 AM   #8
Carlino
 
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Who needs unhelpful doctors when your have a community of support?!
04-09-2013, 05:23 AM   #9
sickinlk
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never heard of this before so yes it has been an education. yay for crohn's forum.
ju
04-09-2013, 07:03 AM   #10
Catherine
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These are the ranges off Sarah's test results

6-TGN 235-450 pmol/8x10^8 RBCs
6-MMP <5,700 pmol/8x10^8 RBCs
6-MMP:6-TGN ratio < 20 (11-20 borderline)

My understanding is they would normal increase the dose as the 6-TGN is low but the 6-MMP is still with in range but at the higher end of normal so it not as clear cut.

These are the notes written on bottom of the test results

Metabolite Result
- very low/absent 6-TGN
- very low/absent 6-MMP

Interpretation
- non-compliance

Suggested action
- Education

Metabolite Result
- low 6-TGN
- low 6-MMP

Interpretation
- under-dosing or poor compliance

Suggested action
- increase dose or Education

Metabolite Result
- Therapeutic 6-TGN
- Therapeutic or high 6-MMP

Interpretation
- thiopurine refractory

Suggested action
- Add or change other therapy

Metabolite Result
- 6-MMP:6TGN ratio >20

Interpretation
- thiopurine resistance -shunting to 6-MMP

Suggested action
- Change to other therapy or use allopurinol + reduce dose to 25%
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Mother of Sarah dx aged 16, Jan 2012
DX - CD 1/12, asthma
Small bowel to small bowel fistula

Meds: ), azathioprine 200mg, Mesalazine 1.2g x 2, seretide 250 x 2 (asthma), ventolin (as needed)

Currently no supplements.

Has previously taken Multi B, Caltrate, B12 & Iron

Prednisolone (from 30 mg 01/02/2012 to 17/06/2012, 30mg 24/10/12-28/12/12, 50mg 24/1/13-27/4/13)
04-09-2013, 10:45 AM   #11
Carlino
 
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Does anyone else have constant itching with Imuran? especially your face? I have red little rash bumps all over my cheeks, but i'm not sure if it's from the Imuran or Prednisone.
04-09-2013, 01:11 PM   #12
2thFairy
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Let your GI know. It could be an allergic reaction.
02-19-2015, 05:14 PM   #13
Rayna
 
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If you are familiar with high levels of TGN, I'd love to hear your thoughts...

Originally diagnosed with Crohn's in 2007, just last year GI didn't see any "Crohn's" in my colonoscopy and now diagnosed me with Ulcerative Colitis instead.

I'm on Imuran - originally 150 but because of my HIGH mmp (over 10,000) I had to add allopurinol to shift the enzyme. But in turn, that increased my TGN (normally supposed to be below 400) mine is now 845.

So I'm reducing imuran further to 25 mg as I don't want to experience any sort of bone marrow suppression in near future.

Do any of you know why if my imuran continues to reduce, why would my TGN keep increasing?? Very bizarre.... I told my GI that maybe I don't even need to be on imuran. So might have to get off the meds if 25 mg still causes an increase in TGN.

Ok, thanks!!
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