Mycophenolate mofetil (MMF) is a widely prescribed immunosuppressive agent after solid organ transplantation. Potential teratogenic effects after in utero exposure to MMF in experimental studies and clinical observations in humans has been postulated in recent literature. However, a specific pattern of malformation has not been identified yet. We present a newborn patient, born to a recipient of renal transplantation, who became pregnant while taking MMF as immunosuppressive therapy. The newborn exhibited cleft lip and palate, bilateral microtia and atretic external auditory canals, chorioretinal coloboma, hypertelorism, and micrognathia. An extensive review of the literature documented six other cases with similar malformations after in utero exposure to MMF. A consistent pattern of malformations comprising cleft lip and palate, microtia and external auditory canals could be observed in five of the six cases. A different malformative pattern observed in one of the patients could be attributed to a different agent rather than MMF. The possible teratogenic effects of other immunosuppressive drugs, such as tacrolimus and prednisone, to which this patient was also exposed, are discussed herein. In addition, the differential diagnosis with other dysmorphic syndromes that can present with a similar phenotype, such as CHARGE syndrome, 18q deletion and hypertelorism-microtia-clefting (HMC) syndrome, is presented. We conclude that in utero exposure to MMF can cause a characteristic phenotype and propose the existence of a mycophenolate-associated embryopathy whose main features are: cleft lip and palate, microtia with atresia of external auditory canal, micrognathia and hypertelorism. Ocular anomalies, corpus callosum agenesis, heart defects, kidney malformations, and diaphragmatic hernia may be part of the phenotypic spectrum of MMF embryopathy. The human teratogenicity of MMF is reinforced by this report, and the current contraceptive recommendations about its use in fertile women are stressed.

Prematurity is associated with protracted oxidative stress, and human milk is partially protective.

Genetic diversity of accessions of the mangaba germplasm bank in Sergipe, BrazilAbstract -The objective of this work was to estimate the genetic variability of mangaba accessions of natural populations, from 11 locations, using RAPD markers. The accessions belong to Banco Ativo de Mangaba of Embrapa Tabuleiros Costeiros, in Itaporanga d'Ajuda, SE, Brazil. A total of 13 primers were used, which generated 82 fragments, of which 78 (95%) were polymorphic. Genetic analysis among regions showed low genetic diversity; however, genetic similarity ranged from 0.02 to 0.91, for the 55 accessions. Divergent groups were identified by UPGMA and ACoP clustering. The least similar accessions were derived from Ipiranguinha (Conde, PB, Brazil) and Preguiça (Indiaroba, SE, Brazil), and the most similar from Jandaíra (Costa Azul, BA, Brazil). From the total, 49 accessions were genetically distinct and six were similar. By using RAPD markers, it was possible to obtain a unique molecular profile, besides estimating the variability among the accessions evaluated. The Banco Ativo de Germoplasma de Mangaba of Embrapa Tabuleiros Costeiros shows low genetic diversity among locations.

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