{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:40:51Z","timestamp":1764740451001,"version":"3.46.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>\n                    Thiopurines are a class of immunosuppressant and antineoplastic agents. They are widely used in the treatment of inflammatory bowel disease, haematological malignancies and autoimmune diseases, but can cause significant toxicity. Inherited gene mutations are now recognized as independent risk factors for severe adverse drug reactions to thiopurines even at 10\u2010fold dose reductions. We present a case of thiopurine toxicity resulting in severe myelosuppression, hepatotoxicity and alopecia in an individual with homozygous *3\/*3 loss\u2010of\u2010function alleles in the\n                    <jats:italic>NUDT15<\/jats:italic>\n                    gene. Our case highlights important differences in gene mutation frequencies between races that can help guide pharmacogenomic testing.\n                  <\/jats:p>","DOI":"10.1002\/bcp.70047","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T06:49:47Z","timestamp":1742280587000},"page":"1511-1515","source":"Crossref","is-referenced-by-count":1,"title":["Severe myelosuppression and alopecia after thiopurine initiation in a patient with\n                    <i>NUDT15<\/i>\n                    deficiency"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7636-7829","authenticated-orcid":false,"given":"Annie Siyu","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Mozessohn","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Division of Medical Oncology\/Hematology Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Odette Cancer Center Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-1632","authenticated-orcid":false,"given":"Richard B.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Western Ontario  London Ontario Canada"},{"name":"Division of Clinical Pharmacology and Toxicology London Health Sciences Center  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan S.","family":"Zipursky","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Division of Clinical Pharmacology and Toxicology Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2292"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2011.11.007"},{"issue":"11","key":"e_1_2_9_4_1","first-page":"RA247","article-title":"Reviewing the mechanism of action of thiopurine drugs: towards a new paradigm in clinical practice","volume":"10","author":"Cara CJ","year":"2004","journal-title":"Med Sci 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assessment of genes implicated in thiopurine metabolism and toxicity in a UK cohort of pediatric patients with inflammatory bowel disease","author":"Coelho T","year":"2024","journal-title":"Inflamm Bowel Dis"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/tpj.2015.43"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.15543"}],"container-title":["British Journal of Clinical 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