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is a membranebound enzyme that preferentially catalyzes the methylation of aliphatic sulfhydryl compounds such as captopril and Dpenicillamine, whereas is a cytoplasmic enzyme that preferentially catalyzes the methylation of aromatic and heterocyclic sulfhydryl compounds including anticancer and immunosuppressive thiopurines such as 6mercaptopurine, 6thioguanine, and azathioprine

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During the day, symptoms often occur when holding something for a prolonged period of time with the wrist bent forward or backward, such as when using a phone, driving, or reading a book