Korean J Pathol.  2010 Jun;44(3):333-337.

Mycophenolate Mofetil-Related Colitis: A Case Report

Affiliations
  • 1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. JaeRo@tmhs.org
  • 2Department of Pathology, Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA.
  • 3Department of Internal Medicine, Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA.

Abstract

Mycophenolate mofetil (MMF)-related colitis is one of the common causes of afebrile diarrhea in transplant patients. Pathologic diagnosis of MMF-related colitis is difficult because microscopic findings of MMF effects resemble those of graft-versus-host disease, inflammatory bowel disease and ischemic colitis. However, if diagnosed, MMF-induced colitis can be markedly improved by discontinuing the drug. A 70-year-old man having a history of transplantation presented with a one month history of afebrile diarrhea. Colonoscopy revealed patchy erosions. The colonoscopic biopsy specimen showed not only crypt disarray with degenerated crypts and scattered epithelial cell apoptosis, but also stromal inflammatory cell infiltration. A review of his medical records showed that he had been taking immunosuppressive drugs including MMF since his heart transplantation 6 years prior. The histologic findings of colonic mucosa were consistent with MMF-related colitis. After discontinuing MMF, the diarrhea quickly resolved and has not recurred for 10 months.

Keyword

Mycophenolate mofetil; Transplants; Diarrhea; Colitis

MeSH Terms

Aged
Apoptosis
Biopsy
Colitis
Colitis, Ischemic
Colon
Colonoscopy
Diarrhea
Epithelial Cells
Graft vs Host Disease
Heart Transplantation
Humans
Inflammatory Bowel Diseases
Medical Records
Mucous Membrane
Mycophenolic Acid
Transplants
Mycophenolic Acid
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