title: Patterns of injury in mycophenolate mofetil-related colitis.
abstract: Mycophenolate mofetil (MMF) was introduced as a new immune-suppression drug in the mid-1990s. It is widely utilized in solid-organ transplantation immune-suppression regimens. Side effects include gastrointestinal (GI) toxicity in the form of nausea, vomiting, and diarrhea. Physicians tend to reduce the dose of MMF or switch their patients to an enterio-coated formula to overcome the side effects. Because GI side effects are well linked to MMF, colonoscopy is not utilized in most of the cases to investigate the diarrhea. However, Crohn's disease-like changes in the colon, erosive enterocolitis, and graft versus host disease-like colonic changes associated with the use of MMF have been reported. Colonic findings in five patients whose symptoms resolved after substituting another agent for MMF are described in the present report. Repeat colonoscopy 4 months following discontinuation of MMF showed reparative changes in one of our patients. MMF is an important drug in organ transplantation immune-suppression regimens; however, with its widespread usage, additional side effects continue to be recognized.
authors.affiliation: Nephrology Department, University of Tennessee Health Science Center, Memphis, Tennessee, USA. aalabsi@uthsc.edu
authors.forename: A I
authors.initials: AI
authors.lastname: Al-Absi
authors.forename: C R
authors.initials: CR
authors.lastname: Cooke
authors.forename: B M
authors.initials: BM
authors.lastname: Wall
authors.forename: P
authors.initials: P
authors.lastname: Sylvestre
authors.forename: M K
authors.initials: MK
authors.lastname: Ismail
authors.forename: M
authors.initials: M
authors.lastname: Mya
mesh_terms: D000328:Adult; D003092:Colitis / Q000139:chemically induced* / Q000473:pathology; D003106:Colon / Q000187:drug effects* / Q000473:pathology; D003113:Colonoscopy; D003967:Diarrhea / Q000139:chemically induced; D057915:Drug Substitution; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D016377:Organ Transplantation; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid