[Diffuse colitis associated with mycophenolate mofetil treatment: apropos of 1 case]

Nephrologie. 2000;21(8):437-9.
[Article in French]

Abstract

Mycophénolate mofétil (MMF) or Cellcept is a potent immunosuppressor that inhibits purin synthesis used to prevent human allograft rejection. The most important secondary effects include haematological and intestinal disorders. Among them, diarrhea is the most common. It is dose-dependant and appears commonly during the first 2 months of treatment. Its physiopathology remains unclear. We reported a case of colitis, 6 months after a kidney transplantation. The patient was treated since day 2 with 2 grams per day of MMF. Morphological analysis showed a diffuse colitis from the coecum to the rectum. Histological samples confirmed a colitis with atrophic crypts but with mucosal secretions and some cryptic abscesses. No granuloma or CMV inclusion was founded. Histochemical immunostaining for CMV was negative. Finally, symptoms regressed within 5 days after tapering down MMF dose in association with metronidazole treatment. The role of MMF in inducing colitis is discussed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Colitis / chemically induced*
  • Colitis / pathology
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation*
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / adverse effects*
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use

Substances

  • Immunosuppressive Agents
  • Metronidazole
  • Mycophenolic Acid