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Mycophenolate mofetil-induced colitis in children

Uma Padhye Phatak1, Patricia Seo-Mayer, Dhanpat Jain

  • 1Yale University School of Medicine, New Haven, CT 06520, USA.

Journal of Clinical Gastroenterology
|July 18, 2009
PubMed

Insights

Severe colitis from Mycophenolate Mofetil (MMF) is rare in children. This report details two pediatric cases, emphasizing MMF-induced colitis as a critical diagnosis for diarrhea in transplant patients.

Area of Science:

  • Pediatric Nephrology
  • Gastroenterology
  • Transplant Medicine

Background:

  • Mycophenolate Mofetil (MMF) is a standard immunosuppressant in pediatric renal transplantation.
  • Gastrointestinal side effects are common, but severe colitis is considered rare and primarily documented in adults.

Observation:

  • Two pediatric renal transplant recipients developed severe colitis.
  • Infectious and other etiologies for diarrhea were excluded.
  • Histologic findings varied, mimicking inflammatory bowel disease and graft-versus-host disease.

Findings:

  • Mycophenolate Mofetil (MMF)-induced colitis was diagnosed in both pediatric patients.
  • Discontinuation of MMF led to complete symptom resolution, establishing a likely causal link.
  • Histological diversity was noted in colonic biopsies.

Implications:

  • These cases highlight the importance of considering MMF-induced colitis in pediatric transplant patients presenting with diarrhea.
  • Early recognition and MMF withdrawal can prevent severe complications.
  • Further investigation into MMF's gastrointestinal effects in pediatric populations is warranted.

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