Mycophenolate-induced eosinophilic colitis: A case report

Authors

DOI:

https://doi.org/10.17533/udea.iatreia.211

Keywords:

Colitis, Mycophenolic Acid, Diarrhea

Abstract

Mycophenolate mofetil is a medication used for the prevention of allograft rejection in organ transplant patients. Eosinophilic colitis due to mycophenolate is a recognized condition in patients with a history of renal transplantation and persistent diarrhea, requiring a biopsy to achieve an appropriate diagnosis and treatment. The case of an 11-year-old boy with diarrhea is presented; colon biopsy showed edema and eosinophilic inflammatory infiltrate in the lamina propria with microabscess formation, with epithelial and crypt damage. Because of the absence of another cause of the clinical case, mycophenolate was withdrawn from the treatment scheme, with resolution of the symptoms. The Naranjo adverse drug reaction probability scale was definitive with a score of 10. It contributes to the literature with the characterization of the histopathological findings in mycophenolate-induced colonic injury.

|Abstract
= 691 veces | PDF (ESPAÑOL (ESPAÑA))
= 205 veces| | HTML (ESPAÑOL (ESPAÑA))
= 0 veces|

Downloads

Download data is not yet available.

Author Biographies

Mario Alberto Caviedes-Cleves, Universidad de Antioquia, Medellín, Colombia

Residente de tercer año de Patología, Universidad de Antioquia, Medellín, Colombia.

Ariel Antonio Arteta-Cueto, Universidad de Antioquia, Medellín, Colombia

Médico Especialista en Patología, Departamento de Patología, Universidad de Antioquia. Medellín, Colombia.

References

(1) Recio-Linares A, Carabaño-Aguado I, Salcedo-Lobato E, García-Rodríguez C, Botija-Arcos G, Valencia-Mesa AL. Colitis eosinofílica: hay que pensar en ella. Rev Pediatr Aten Primaria [Internet]. 2019;21(84):405–10. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322019000400016#:~:text=En%20resumen%3A%20cabe%20pensar%20en,coexiste%20una%20base%20al%C3%A9rgica%2Dat%C3%B3pica.

(2) Prieto-Ortiz RG, Prieto-Ortiz JE. (2020). Colitis eosinofílica, un diagnóstico poco sospechado. Rev Colomb Gastroenterol [Internet]. 2020;35(1):87–91. https://doi.org/10.22516/25007440.376

(3) Díaz del Arco C, Taxonera C, Olivares D, Fernández-Aceñero MJ. Eosinophilic colitis: Case series and literature review. Pathol Res Pract [Internet]. 2018;214(1):100–4. https://doi.org/10.1016/j.prp.2017.09.029

(4) Calle-Gómez M, Sierra-Quiroz Y, Ochoa-García C, Vélez-Echeverri C, Serna-Higuita LM, Pérez-Cadavid JC, et al. Colitis eosinofílica secundaria a tacrolimus en un paciente pediátrico trasplantado renal. Reporte de caso. Nefroplus [Internet]. 2018;10(2):68–71. Disponible en: https://www.revistanefrologia.com/es-colitis-eosinofilica-secundaria-tacrolimus-un-articulo-X1888970018633889

(5) Allison AC, Eugui EM. Mycophenolate mofetil and its mechanisms of action. Immunopharmacology. 2000;47(2–3):85–118. https://doi.org/10.1016/s0162-3109(00)00188-0

(6) Farooqi R, Kamal A, Burke C. Mycophenolate-induced colitis: A case report with focused review of literature. Cureus [Internet]. 2020;12(1):e6774. https://doi.org/10.7759/cureus.6774

(7) Davies NM, Grinyó J, Heading R, Maes B, Meier-Kriesche H-U, Oellerich M. Gastrointestinal side effects of mycophenolic acid in renal transplant patients: a reappraisal. Nephrol Dial Transplant [Internet]. 2007;22(9):2440–8. https://doi.org/10.1093/ndt/gfm308

(8) Johal K, Ratuapli SK, Lam-Himlin DM, Gurudu SR. Mycophenolate mofetil-induced segmental colitis mimicking ischemic colitis. Case Rep Gastroenterol [Internet]. 2014;8(1):95–100. https://doi.org/10.1159/000360847

(9) Calmet FH, Yarur AJ, Pukazhendhi G, Ahmad J, Bhamidimarri KR. Endoscopic and histological features of mycophenolate mofetil colitis in patients after solid organ transplantation. Ann Gastroenterol [Internet]. 2015;28(3):366–73. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480174/

(10) Pineton de Chambrun G, Dufour G, Tassy B, Rivière B, Bouta N, Bismuth M, et al. Diagnosis, natural history and treatment of eosinophilic enteritis: A review. Curr Gastroenterol Rep [Internet]. 2018;20(8):37. https://doi.org/10.1007/s11894-018-0645-6

(11) Kim K, Gardner JM, Schwartz M, Tompson ML, Ro JY. Mycophenolate mofetil-related colitis - A case report -. Korean J Pathol [Internet]. 2010;44(3):333. https://doi.org/10.4132/KoreanJPathol.2010.44.3.333

(12) Dunstone GH. A case of eosinophilic colitis. Br J Surg [Internet]. 1959;46(199):474–6. https://doi.org/10.1002/bjs.18004619913

(13) Mansoor E, Saleh MA, Cooper GS. Prevalence of eosinophilic gastroenteritis and colitis in a population-based study, from 2012 to 2017. Clin Gastroenterol Hepatol [Internet]. 2017;15(11):1733–41. https://doi.org/10.1016/j.cgh.2017.05.050

(14) Patil DT, Odze RD. Biopsy diagnosis of colitis: an algorithmic approach. Virchows Arch [Internet]. 2018;472(1):67–80. https://doi.org/10.1007/s00428-017-2274-0

(15) Suthanthiran M, Morris RE, Strom TB. Immunosuppressants: cellular and molecular mechanisms of action. Am J Kidney Dis [Internet]. 1996;28(2):159–72. https://doi.org/10.1016/s0272-6386(96)90297-8

(16) Goyal A, Salahuddin M, Govil Y. A unique case of mycophenolate induced colitis after 10 years of use. Case Rep Gastrointest Med [Internet]. 2016; 2016:3058407. https://doi.org/10.1155/2016/3058407

(17) Kiss Z, Tél B, Farkas N, Garami A, Vincze Á, Bajor J, et al. Eosinophil counts in the small intestine and colon of children without apparent gastrointestinal disease: A meta-analysis. J Pediatr Gastroenterol Nutr [Internet]. 2018;67(1):6–12. https://doi.org/10.1097/MPG.0000000000001904

(18) Papadimitriou JC, Drachenberg CB, Beskow CO, Cangro C, Wiland A, Klassen D, et al. Graft-versus-host disease-like features in mycophenolate mofetil-related colitis. Transplant Proc [Internet]. 2001;33(3):2237–8. https://doi.org/10.1016/s0041-1345(01)01951-0

(19) Kumar NB, Nostrant TT, Appelman HD. The histopathologic spectrum of acute self-limited colitis (acute infectious-type colitis). Am J Surg Pathol [Internet]. 1982;6(6):523–9. https://doi.org/10.1097/00000478-198209000-00004

Published

2023-02-21

How to Cite

1.
Caviedes-Cleves MA, Arteta-Cueto AA. Mycophenolate-induced eosinophilic colitis: A case report . Iatreia [Internet]. 2023 Feb. 21 [cited 2025 Dec. 5];36(2). Available from: https://revistas.udea.edu.co/index.php/iatreia/article/view/350533

Issue

Section

Case reports