Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Feb 24, 2017; 7(1): 98-102
Published online Feb 24, 2017. doi: 10.5500/wjt.v7.i1.98
Mycophenolate mofetil toxicity mimicking acute cellular rejection in a small intestinal transplant
Ross Apostolov, Khashayar Asadi, Julie Lokan, Ning Kam, Adam Testro
Ross Apostolov, Khashayar Asadi, Julie Lokan, Ning Kam, Adam Testro, Australian Intestinal Transplant Service, Austin Health, Heidelberg, VIC 3084, Australia
Author contributions: Apostolov R, Asadi K, Lokan J and Testro A contributed to writing and revising the paper; all authors contributed to the acquisition and interpretation of data.
Institutional review board statement: This case report was exempt from ethics approval by our Institute’s Ethics Committee.
Informed consent statement: The patient involved in this study gave his informed consent authorising use and disclosure of his anonymised health information and pathology slides.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adam Testro, MBBS, FRACP, PhD, Head of Intestinal Rehabilitation and Transplantation, Australian Intestinal Transplant Service, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia. adam.testro@austin.org.au
Telephone: +61-3-94965353 Fax: +61-3-94963487
Received: November 26, 2016
Peer-review started: November 29, 2016
First decision: December 15, 2016
Revised: December 21, 2016
Accepted: January 11, 2017
Article in press: January 13, 2017
Published online: February 24, 2017
Core Tip

Core tip: Mycophenolate mofetil (MMF) is a commonly used medication for maintenance immunosuppression in small intestine transplant (SIT) recipients. Enterocolitis is a known side effect of MMF therapy, but there is little literature describing its histological manifestations in SIT recipients. Our case shows that MMF enterocolitis can mimic acute cellular rejection (ACR) and highlights the importance of attempting to biopsy the native gastrointestinal tract in SIT recipients if possible. If the native biopsy is abnormal, drug toxicity should be considered as a differential diagnosis as it may show overlapping features with ACR.