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10-07-2013, 09:23 AM   #1
QueenGothel
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Prometheus testing

Does any one know what this means.

TPMT Enzyme See Comment
TPMT Enzyme Activity
NORMAL ACTIVITY
Result: 24.0 EU

Reference Ranges: >21.0 EU - Normal Activity
6.0-21.0 EU - Intermediate Activity
<6.0 EU - Low Activity

The highest TPMT enzyme activity level observed in the
Prometheus validation studies of normal individuals was
between 60-70 EU.
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This is the Prometheus Testing results as I can now view her results online. Does this look like it is lacking a lot of information or am I crazy. This was to test her for Crohns.
10-07-2013, 10:00 AM   #2
Jmrogers4
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Is this from the prometheus prognostic? It seems like there was a lot more information on Jack's, There was also a portion about genetic markers on Jack's test. I'm at work so I can't pull it (they cut me off from being able to see his test results - even past one when he turned 14 in July), but I will look tonight.
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Jacqui

Mom to Jack (18) dx Crohn's 2/2010
Vitamin D -2000mg
Remicade - started 1/9/14; 7.5ml/kg every 6 weeks
Centrum for Him teen multivitamin
Past meds: Imuran/Azathioprine; allopurinol; methotrexate; LDN; Prednisone; Apriso; Pentasa; EEN

Husband dx Crohn's 3/1993
currently none due to liver issues
10-07-2013, 10:03 AM   #3
QueenGothel
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Test performed by: Prometheus Laboratories
9410 Carroll Park Drive
San Diego, CA

I should be getting a zip drive soon with all of her records complete with all tests, MRE and everything I could possibly need for a second opinion. Hoping there is more info on it and that the online portal just isn't very good. Why even have it if you cannot use it. Kinda dumb.
10-07-2013, 10:07 AM   #4
my little penguin
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The tmpt test is done to determine if your system can process Imuran or 6-mp.
That isn't the genetic crohn's test as far as I know .
10-07-2013, 10:09 AM   #5
my little penguin
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The tests for thiopurine methyltransferase (TPMT) enzyme activity or its underlying genetics are measured in people who are about to start treatment with a thiopurine drug. One or the other of these tests is used to identify individuals at risk of developing severe side effects from thiopurine therapy.

People who have low enzyme activity have an increased risk of side effects, and those who are severely deficient are likely to experience serious side effects such as suppression of the bone marrow. When the bone marrow is suppressed, it is unable to produce sufficient numbers of red blood cells, white blood cells, and platelets. This may result in a significant drop in blood cell counts, leading to complications such as anemia, serious infections, and/or excessive bleeding. These complications may be life-threatening.

Thiopurines such as azathioprine, mercaptopurine, and thioguanine are drugs that are prescribed for diseases such as acute lymphoblastic leukemia (ALL), inflammatory bowel disease, and autoimmune disorders. They may also be prescribed for organ transplant recipients to help prevent organ rejection.

From
http://labtestsonline.org/understand.../tpmt/tab/test
10-07-2013, 10:12 AM   #6
Jmrogers4
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There are some sample reports on the Wiki for Prometheus IBD http://www.crohnsforum.com/wiki/Prom...sgi-Diagnostic
That is what Jack's report looked like. There was also a second page with a graph and it showed likely hood of complications based on testing. Which was the NOD2/CARD 15 genetic testing.
10-07-2013, 10:16 AM   #7
QueenGothel
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So her surgeon did not even test her for the right stuff. Hmmm... So glad she didn't think I needed a GI because they know everything. (Can you sense the sarcasm?) I guess I can have it repeated at our Oct 22nd appointment with her new GI at Mott. Very irritated, being she told me it was all good and no Crohns when she didn't even know what she tested her for.
10-07-2013, 10:21 AM   #8
Jmrogers4
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Usually takes a couple of weeks on the genetic testing maybe surgeon just checked all the boxes? Just trying to be Ms. Polly Sunshine
10-07-2013, 01:41 PM   #9
araceli
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When I saw the results for my son's test on line, not all the info was there. When I got the copy from Doc it had a lot more. His was order to see if he had generic markers for IBD and if positive to check for Crohn's. So I did not see anything about enzymes. His test came negative but his biopsies show positives, In my opinion the test is not 100% reliable. I hope your Doctor has more info and everything is ok.
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Mom/ Girl 19
dx 2011 crohn's in terminal ileum, peri-anal
Prior Meds Asacol, Prednisone, nexium
Current meds.
Remicade since Nov. 2012
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Currently in REMISSION :dance

Mom/ 16 boy
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10-07-2013, 01:56 PM   #10
DustyKat
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MLP is right Mary, TPMT is the test to see if you have the enzyme to process the thiopurines and so be forewarned of your chances of developing the serious side effects of the drug. If levels are non existent or low then it should indicate to the GI what course of action to take if thiopurines are going to be prescribed.

Dusty. xxx
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10-07-2013, 02:08 PM   #11
DanceMom
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As others have explained, Prometheus Laboratories has several different tests related to IBD. The TPMT test, which you posted the results for, is to determine how the body will handle medications like 6-mp.

A had the TPMT test, but she also had the test for genetic markers of IBD and hers did indicate Crohn's Disease. I don't have the results in front of me now, but I remember that there were genetic markers (of which she had several) and inflammatory markers (she had one). This test was ridiculously expensive and insurance would not cover it despite 3 appeals. It was helpful though because it was further evidence that she did have CD. I believe it took nearly 2 weeks to get the results.
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Diagnoses: Immune Dysfunction, Hypogammaglobulinemia, Asthma, Allergies

Treatment: Hizentra, Flovent, Zyrtec, Cellcept
10-08-2013, 09:43 AM   #12
QueenGothel
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So the test I want is called... Prometheus test for genetic markers of IBD. Is there another name for it? I want to make sure they send the right one off next time. Thanks Everyone for clarifying.
10-08-2013, 09:47 AM   #13
QueenGothel
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Or Prometheus IBD SGI Diagnostic
10-08-2013, 09:48 AM   #14
Jmrogers4
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It is the Prometheus IBD sgi Diagnostic. There is also the NOD2/Card15 which tests for specific markers like NOD2 which can give you an idea of possible severity of the disease. NOD2 is supposed to coincide with higher cases of stricturing/fistulizing disease.
Jack's came together but I believe they are separate tests. Jack's doctor just called it the Promethus prognostic
10-09-2013, 01:20 AM   #15
Patricia56
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Be aware that the prometheus serological marker testing (the IBD SGI) is considered moderately unreliable by many GI's and they will not order it for that reason. I can get you statistics if you want but the bottom line is that you would not want to use the results to decide what color to paint the baby's bedroom, if you know what I mean.

It appears to be most useful for identifying people who do NOT have CD or UC. If the test says you don't have it - you probably don't have it. If it says you do have CD or UC then maybe you do - and maybe you don't since there's a high rate of false positives.

The test results are sometimes a helpful adjunct in cases of IC or other odd findings.

As with most testing, it is all a matter of looking at the whole picture - the physical findings of the child and any scopes, the biopsies, labs and other tests like these must all fit together in a way that makes sense.
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Dxd age 10, 2006 after nearly 1 year of active sx
Current CD meds: Remicade, Methotrexate and Omeprazole, Vit. D, Calcium, Folic Acid, Probiotic

Nothing I say here should be construed as medical advice. I am not a doctor. These are just my opinions.
10-12-2013, 08:13 AM   #16
QueenGothel
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Yes, it was recommended by Cincinnati though because we need to do all the testing to check for any chance of Crohns before I am willing to do another restorative proctocolectomy. I am aware it is a piece to the puzzle, just making sure we have all the pieces in place before I make any decisions regarding more surgeries for her as from here on out the J-Pouch is now elective. Well it was before but it was different because they had to be in there removing the colon so before I figured if we are going to try it lets do it all in one surgery. I know it is not 100% but the surgeon in Cincy said they have improved on the distinguishing UC vs Crohns part of the Prometheus test 18% in the last 2 years. If it comes back Crohns I am not doing the surgery unless she wants it in like 10 years, so long as she is not symptomatic until then.

Last edited by QueenGothel; 10-12-2013 at 08:36 AM.
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