Mycophenolate-Induced Colitis

Farooqi, Rehan; Kamal, A. N.; Thind, Komal; Burke, Carol A.

doi:10.14309/00000434-201810001-01546

Cited by 2 publications

(3 citation statements)

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“…MMF is a commonly prescribed adjunct immunosuppressive agent in transplant therapy. Up to 45% of patients report diarrhea, vomiting, and abdominal pain; diarrhea being the most commonly reported side effect [4,5]. As an immunosuppressant, MMF can affect the entire gastrointestinal system leading to clinical complications ranging from esophagitis, gastroesophageal reflux disease, to enteritis and colitis.…”

Section: Discussionmentioning

confidence: 99%

“…As an immunosuppressant, MMF can affect the entire gastrointestinal system leading to clinical complications ranging from esophagitis, gastroesophageal reflux disease, to enteritis and colitis. Development of diarrhea due to enteritis and/or colitis can be difficult to recognize as only 2%-9% of patients on MMF develop these complications [5,6]. Pathology can resemble inflammatory bowel disease, graft-versushost disease (GVHD), acute colitis or ischemia [6].…”

Section: Discussionmentioning

confidence: 99%

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Mycophenolate-induced Colitis: A Case Report with Focused Review of Literature

Farooqi

Kamal

Burke

2020

Cureus

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Mycophenolate mofetil (MMF) is an immunosuppressive medication used for the management of various autoimmune diseases, and patients with bone marrow and solid organ transplants. Gastrointestinal side effects are seen 45% of the time and they include nausea (29%), vomiting (23%), constipation (38%), diarrhea (50%-92%), and colitis (9%). In 98% of cases, resolution of diarrhea occurs within 20 days upon discontinuation of the MMF. Data is scarce regarding approach in the treatment of MMF-induced colitis. We report a case of MMF-induced colitis diagnosed by colonoscopy and histopathology. This case illustrates the challenges encountered while managing MMF-induced colitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mycophenolate-induced Colitis: A Case Report with Focused Review of Literature

Farooqi

Kamal

Burke

2020

Cureus

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“…Methylprednisolone, which successfully reduced our patient’s symptoms, works by suppressing the synthesis of cyclooxygenase (COX)-2, which helps to limit the inflammation cascade in damaged tissues due to decreased prostaglandin production [ 5 ]. In a separately reported case of mycophenolate-induced colitis, IV methylprednisolone helped to improve symptoms of bloody diarrhea in a patient [ 6 ]. In another case, IV methylprednisolone was used to treat diarrhea caused by inflammatory bowel disease [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Intravenous Steroids for Refractory Chemotherapy-Related Diarrhea: A Case Report

Patel¹,

Dang²,

Makhlouf³

et al. 2023

Cureus

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The clinical course of a patient with chemotherapy-related diarrhea (CRD) refractory to standard therapy was monitored over the course of 21 days. The patient was minimally responsive to traditional treatment options, including bismuth subsalicylate, diphenoxylate-atropine, loperamide, octreotide, and oral (PO) steroids, and exhibited reportable improvements with the addition of intravenous (IV) methylprednisolone to other antidiarrheal agents. We present a case of CRD in an 82-year-old female. She was initiated on chemotherapy three weeks prior and has experienced severe diarrhea since her initiation. Despite the use of first-line antidiarrheal therapies, including loperamide, diphenoxylate-atropine, and octreotide, both subcutaneously and via continuous infusion drip, no infectious cause was found. She also received the nonabsorbing corticosteroid budesonide, but her diarrhea persisted. After experiencing severe hypotension and hypovolemia secondary to profuse diarrhea, she was placed on IV steroids, which quickly reduced her symptoms. The patient was then transitioned to oral steroids and discharged on a tapering regimen. We recommend using IV steroids to treat CRD if first-line therapies fail. Utilizing IV steroids efficiently and effectively can decrease the symptoms of persistent diarrhea and lead to rapid recovery.

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Mycophenolate-Induced Colitis

Cited by 2 publications

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Mycophenolate-induced Colitis: A Case Report with Focused Review of Literature

Mycophenolate-induced Colitis: A Case Report with Focused Review of Literature

Intravenous Steroids for Refractory Chemotherapy-Related Diarrhea: A Case Report

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