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Mycophenolate Induced Colitis: One-year Post-kidney Transplantation.
Waleed Al Saadi1, Issa Al Salmi1,2, Ehab Mohammed2
1Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat, Oman.
Oman Medical Journal
|May 3, 2023
Summary
Mycophenolate mofetil (MMF) can cause colitis in kidney transplant patients. Stopping MMF and switching immunosuppressants resolved symptoms in a young female patient, highlighting this adverse effect.
Area of Science:
- Nephrology
- Gastroenterology
- Pharmacology
Background:
- End-stage kidney disease (ESKD) incidence is rising, with kidney transplantation as a primary treatment.
- Mycophenolate mofetil (MMF) is a common immunosuppressant in solid organ transplantation.
- Metabolic syndrome is a contributing factor to the increasing rates of ESKD.
Observation:
- A young female kidney transplant recipient presented with a three-month history of watery, non-bloody diarrhea.
- Colonoscopy revealed histopathological features consistent with MMF-induced colitis, including increased crypt apoptosis and architectural disarray.
- The patient had undergone a living-related kidney transplant.
Findings:
- The case confirmed Mycophenolate mofetil (MMF)-induced colitis as the cause of the patient's chronic diarrhea.
- Histopathology of colonic biopsies provided diagnostic evidence of MMF-induced colitis.
- The patient's symptoms resolved completely after MMF was discontinued and replaced with an alternative immunosuppressant.
Implications:
- This case underscores the importance of considering MMF-induced colitis in transplant patients presenting with gastrointestinal symptoms.
- Understanding the clinical features and pathogenesis of MMF-induced colitis is crucial for timely diagnosis and management.
- Early recognition and intervention can lead to complete symptom resolution and improved patient outcomes in renal transplant recipients.
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