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[Duodenal villous atrophy associated with Mycophenolate mofetil: report of one case]

Oscar Tapia1, Miguel Villaseca, Armando Sierralta

  • 1Departamento de Anatomía Patológica, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile. otescalona@gmail.com

Revista Medica De Chile
|July 30, 2010
PubMed

Insights

Mycophenolate mofetil (MMF), an immunosuppressant, can cause gastrointestinal issues like diarrhea. Discontinuing MMF in a heart transplant patient resolved severe diarrhea and duodenal villous atrophy, suggesting a drug-induced enteropathy.

Area of Science:

  • Gastroenterology
  • Immunology
  • Transplant Medicine

Background:

  • Mycophenolate mofetil (MMF) is a key immunosuppressant post-transplant.
  • Gastrointestinal side effects, including diarrhea, are common with MMF.
  • Managing MMF's adverse reactions is crucial for patient recovery.

Observation:

  • A heart transplant recipient developed severe diarrhea, anorexia, and weight loss six months post-transplant.
  • Duodenal biopsy revealed villous atrophy, prompting investigation for other causes.
  • Celiac disease and parasitic infections were ruled out.

Findings:

  • Discontinuation of mycophenolate mofetil led to rapid resolution of diarrhea within a week.
  • Subsequent duodenal biopsy showed normalization of villous structure.
  • The patient regained weight and became asymptomatic.

Implications:

  • This case highlights mycophenolate mofetil-induced enteropathy as a potential cause of villous atrophy in transplant patients.
  • Early recognition and drug withdrawal can reverse MMF-related gastrointestinal damage.
  • Consideration of drug-induced enteropathy is vital in transplant recipients presenting with unexplained GI symptoms.

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