title: Esophageal atresia and prenatal exposure to mycophenolate.
abstract: Mycophenolate mofetil is a widely prescribed immunosuppressive agent for transplant patients and autoimmune diseases. Potential teratogenic effects after in utero exposure to mycophenolate mofetil has been described in human clinical observations. The complete clinical pattern is still being delineated. We present four newborns with esophageal atresia and other congenital anomalies, prenatally exposed to mycophenolate mofetil during the first trimester. Two of the cases had other defects related to the embryopathy: microtia, eye abnormalities and oral clefts. Two cases did not show major craniofacial anomalies. We propose that esophageal atresia with or without tracheoesophageal fistula is a feature of mycophenolate embryopathy even without the presence of other major craniofacial anomalies. The human teratogenicity of MMF is reinforced by this report, and the current contraceptive recommendations about its use in fertile women are stressed.
authors.affiliation: National Center of Medical Genetics "Dr Eduardo Castilla", Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: maria_cecilia_martin@yahoo.com.ar.
authors.forename: M C
authors.initials: MC
authors.lastname: Martín
authors.affiliation: Neonatology Service, Penna Hospital, Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: ecristiano@speedy.com.ar.
authors.forename: E
authors.initials: E
authors.lastname: Cristiano
authors.affiliation: Medical Genetics Service, Elizalde Hospital, Buenos Aires, Argentina. Electronic address: mervi3178@yahoo.com.ar.
authors.forename: M
authors.initials: M
authors.lastname: Villanueva
authors.affiliation: Neonatology Service, Regional Hospital of Río Cuarto, Córdoba, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: drabonora@gmail.com.
authors.forename: M L
authors.initials: ML
authors.lastname: Bonora
authors.affiliation: Neonatology Service, Regional Hospital of Río Cuarto, Córdoba, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: nydiaberguio@yahoo.com.ar.
authors.forename: N
authors.initials: N
authors.lastname: Berguio
authors.affiliation: Neonatology Service, Argerich Hospital, Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: anatocci_52@live.com.ar.
authors.forename: A
authors.initials: A
authors.lastname: Tocci
authors.affiliation: National Center of Medical Genetics "Dr Eduardo Castilla", Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: bgroisman@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Groisman
authors.affiliation: National Center of Medical Genetics "Dr Eduardo Castilla", Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: mariapazbidondo@gmail.com.
authors.forename: M P
authors.initials: MP
authors.lastname: Bidondo
authors.affiliation: National Center of Medical Genetics "Dr Eduardo Castilla", Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: rosaliascovich@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Liascovich
authors.affiliation: National Center of Medical Genetics "Dr Eduardo Castilla", Buenos Aires, Argentina; National Registry of Congenital Anomalies of Argentina (RENAC), Argentina. Electronic address: pablobarbero63@hotmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Barbero
mesh_terms: D000328:Adult; D004933:Esophageal Atresia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Drug induced abnormalities; Esophageal atresia; Mycophenolate mofetil; Teratogen