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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Related Experiment Video

Updated: Sep 27, 2025

Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model
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Mycophenolate-Induced Colitis in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy Patients.

Monica M Schmitt1, Elise M N Ferré1, Michelly Sampaio De Melo2

  • 1Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy & Infectious Diseases (NIAID), NIH, Bethesda, MD, USA.

JPGN Reports
|April 15, 2022
PubMed
Summary

Mycophenolate treatment can cause reversible colitis in patients with Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED). This complication, though uncommon, requires clinical vigilance in APECED patients undergoing immunomodulatory therapy.

Keywords:
AIREAPECEDAPS-1colitismycophenolate

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Area of Science:

  • Immunology
  • Gastroenterology
  • Genetics

Background:

  • Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) is a rare autoimmune disorder resulting from AIRE gene mutations.
  • While APECED affects multiple organs, colonic involvement is infrequent.
  • Mycophenolate is a key immunosuppressant for managing autoimmune conditions, including APECED.

Purpose of the Study:

  • To investigate the incidence and characteristics of mycophenolate-induced colitis in APECED patients.
  • To assess the reversibility and histological features of this adverse event.

Main Methods:

  • Retrospective review of clinical, laboratory, genetic, histological, and treatment data.
  • Analysis of a cohort of 104 APECED patients, with a focus on those treated with mycophenolate.

Main Results:

  • Four out of ten (40%) mycophenolate-treated APECED patients developed biopsy-proven colitis.
  • The colitis exhibited histological patterns similar to inflammatory bowel disease or graft-versus-host disease.
  • The condition was reversible upon discontinuation of mycophenolate.

Conclusions:

  • Mycophenolate-induced colitis is a notable complication in APECED patients.
  • Clinicians should maintain a high index of suspicion for this adverse effect in APECED patients on mycophenolate therapy.