Table 1.

Checklist for Evaluation of a Patient Prior to Initiation of Thiopurine Therapy

Clinical history

Age

Sex

Pregnancy/lactation

Ethnicity

Comorbidities

Diabetes mellitus

Hypertension

Metabolic syndrome

Nonalcoholic fatty liver disease

Obesity

Chronic liver disease

Addictions

Alcohol

Smoking

Drug history

History of blood transfusion

Past/family history of malignancy

Laboratory testing

Complete blood count including mean corpuscular volume

Liver function tests

Renal function tests

Blood glucose

Screen for infections

Hepatitis B: HBsAg, anti-HBs titers

Hepatitis C: anti-HCV

Human immunodeficiency virus: anti-HIV

Hepatitis A: anti-HAV IgG

Varicella zoster: anti-VZV IgG

Epstein-Barr virus: VCA IgM/IgG, EBNA IgG

Vaccination

Influenza

Pneumococcal pneumonia

Hepatitis A

Hepatitis B

Human papillomavirus

Varicella zoster

Herpes zoster

Tetanus, diphtheria, pertussis (Tdap)

Pharmacogenetic biomarkers

NUDT15

TPMT

HBsAg, hepatitis B surface antigen; anti-HBs, antibody to hepatitis B surface antigen; anti-HCV, antibody to hepatitis C virus; anti-HIV, antibody to human immunodeficiency virus; anti-HAV, antibody to hepatitis A virus; IgG, immunoglobulin G; anti-VZV, antibody to varicella zoster virus; VCA, viral-capsid antigen; EBNA, Epstein-Barr nuclear antigen; NUDT15, nucleotide diphosphate-linked moiety X-type motif 15; TPMT, thiopurine-S-methyltransferase.