Mycophenolate Mofetil-Induced Colonic Injury Manifesting Endoscopically As Ischemic Colitis

Area of Science:

• Gastroenterology
• Transplant Medicine
• Pharmacology

Background:

• Mycophenolate mofetil (MMOF) is a vital immunosuppressant for kidney transplant recipients.
• Diarrhea is a frequent side effect, often prompting endoscopic evaluation.
• MMOF-induced colitis can present with diffuse ulcers and colitis changes.

Observation:

• This case report details an adult male kidney transplant recipient with histopathologically confirmed MMOF-induced colitis.
• The patient exhibited gross endoscopic findings suggestive of ischemic colitis.
• This presentation is an unusual manifestation of MMOF toxicity.

Findings:

• MMOF-induced colitis can rarely present with endoscopic features mimicking ischemic colitis.
• Histopathology confirmed the diagnosis of MMOF-induced colitis.
• The case underscores the spectrum of gastrointestinal side effects associated with MMOF.

Implications:

• Gastroenterologists must consider MMOF-induced colitis in transplant patients with unexplained colitis, even with ischemic-like endoscopic findings.
• Awareness of these rare presentations can prevent misdiagnosis and guide appropriate treatment adjustments.
• This highlights the importance of correlating endoscopic findings with patient medication history and histopathology.