Metabolism of azathioprine to 6-thioguanine nucleotides in patients with pemphigus vulgaris.

Azathioprine metabolism, to red cell 6-thioguanine nucleotides (6TGN), was studied in four patients with pemphigus vulgaris. Throughout treatment blood samples were taken for red cell 6TGN assay and differential white cell counts. Metabolite steady-state occurred in three patients in 2, 2 and 4 months respectively. In the fourth patient red cell 6TGN concentrations increased slowly over 3 years. There was a significant negative correlation between 6TGN concentrations and the white blood cell count (rs = -0.92, P less than 0.0005) in this patient.