Graft-versus-Host Disease-Like Pattern in Mycophenolate Mofetil Related Colon Mucosal Injury: Role of FISH in Establishing the Diagnosis

Mycophenolate mofetil (CellCept®), a commonly used immunosuppressive drug in solid organ transplantation, has recently been shown to cause graft-versus-host disease (GVHD)-like changes in the gastrointestinal tract. On rare occasions, true GVHD has also been documented in the gastrointestinal tract...

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Bibliographic Details
Published in:Case reports in gastroenterology 2009-12, Vol.3 (3), p.418-423
Main Authors: Behling, Kathryn C., Foster, Dorothy M.J., Edmonston, Tina B., Witkiewicz, Agnieszka K.
Format: Article
Language:English
Subjects:
Colitis
Fluorescence in situ hybridization
Graft-versus-host disease
Heart transplantation
Mycophenolate mofetil
Published: December 2009
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Summary:Mycophenolate mofetil (CellCept®), a commonly used immunosuppressive drug in solid organ transplantation, has recently been shown to cause graft-versus-host disease (GVHD)-like changes in the gastrointestinal tract. On rare occasions, true GVHD has also been documented in the gastrointestinal tract of solid organ transplant patients. Because the treatment for these two entities is different, i.e. removal of the offending agent versus the administration of steroids, proper identification of the cause is imperative. We present a case of mycophenolate mofetil colitis mimicking grade I GVHD of the gut. In our study, we used fluorescence in situ hybridization for the Y chromosome to document the lack of male donor lymphocytes in the female recipient colon biopsy. We suggest that molecular techniques including fluorescence in situ hybridization could be used to discriminate between MMF-related colitis and true GVHD in order to help guide therapy.
ISSN:1662-0631
1662-0631
DOI:10.1159/000260903