title: Fever and pneumonitis induced by enteric-coated mycophenolate sodium in a patient after kidney transplantation.
abstract: Here, we report on a patient after kidney transplantation, who developed fever and pneumonitis due to mycophenolic acid (MPA) treatment. Decreasing MPA dosages improved the symptoms, but after rechallenge with higher MPA doses the symptoms recurred. Discontinuation of MPA resulted in a complete resolution of fever within 24 h and a rapid improvement in pneumonitis. In vitro, the patient's polymorphonuclear neutrophils (PMNs) developed increased oxidative burst when incubated with MPA and N-formyl Met-Leu-Phe. We first report on MPA-induced pneumonitis and show that MPA can induce a pro-inflammatory response in kidney-transplanted patients. These pro-inflammatory changes might be due to paradoxical activation of PMNs.
authors.affiliation: Medical University of Graz, Clinical Division of Nephrology, Graz, Austria.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Pocivalnik
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Kirsch
authors.forename: Eva M
authors.initials: EM
authors.lastname: Hassler
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rosenkranz
authors.forename: Kathrin
authors.initials: K
authors.lastname: Eller
mesh_terms: D005334:Fever / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects*; D009504:Neutrophils / Q000187:drug effects / Q000378:metabolism; D011014:Pneumonia / Q000139:chemically induced*; D016897:Respiratory Burst / Q000187:drug effects; D013608:Tablets, Enteric-Coated
chemical_list: D007166:Immunosuppressive Agents; D013608:Tablets, Enteric-Coated; D009173:Mycophenolic Acid