Mycophenolate mofetil and bronchiectasis in kidney transplant patients: a possible relationship.
Bronchiectasis is a rare acquired condition, generally resulting from long-term chronic pulmonary inflammation. Mycophenolate mofetil (in short, mofetil) is a commonly used immunosuppressant in kidney transplantation. In the literature, there is no report of a relationship between mofetil use and development of bronchiectasis. Five kidney transplant patients developed complaints of cough, dyspnea, and abundant sputum production without apparent cause. Pulmonary complaints started at a range of 0-20 months after the start of mofetil treatment. Lesions were classified as bronchiectasis(-like), based on clinical presentation, chest x-ray, and computed tomography scan. Withdrawal of mofetil greatly relieved pulmonary complaints. Since the first kidney transplantation in our center in 1968, we have had no diagnosis of bronchiectasis in over 1,500 patients without mofetil treatment. These cases suggest an association between mofetil and development of bronchiectasis. Converting mofetil to another immunosuppressive drug should be considered when unexplained pulmonary complaints develop in patients receiving mofetil.
Rook
Mieneke
M
Department of Medicine, Division of Nephrology, Renal Transplant Unit, University Medical Center Groningen, Groningen, The Netherlands. m.rook@int.umcg.nl
Postma
Dirkje S
DS
van der Jagt
Eric J
EJ
van Minnen
Cees A
CA
van der Heide
Jaap J Homan
JJ
Ploeg
Rutger J
RJ
van Son
Willem J
WJ
D000328:Adult; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid