霉酚酸酯诱发的节段性结肠炎酷似缺血性结肠炎。
Mycophenolate mofetil-induced segmental colitis mimicking ischemic colitis.
作者信息
Johal Kevin, Ratuapli Shiva K, Lam-Himlin Dora M, Gurudu Suryakanth R
机构信息
Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz., USA.
出版信息
Case Rep Gastroenterol. 2014 Mar 19;8(1):95-100. doi: 10.1159/000360847. eCollection 2014 Jan.
Mycophenolate mofetil (MMF) is a commonly used drug in the prevention of allograft rejection in patients with solid organ transplants. Although diffuse colitis has been described in MMF-related colitis, segmental colitis has not been reported. We report the case of a 64-year-old male on MMF therapy who presented for evaluation of afebrile diarrhea and abdominal pain. Flexible sigmoidoscopy revealed a segmental erythematous mucosa with ulceration in the sigmoid colon, descending colon, splenic flexure and proximal transverse colon. Biopsies of these areas showed dilated damaged crypts, eosinophilic epithelial changes and crypt abscesses with apoptotic bodies consistent with MMF-induced injury. MMF was discontinued, leading to a significant improvement of his symptoms.
霉酚酸酯（MMF）是实体器官移植患者预防同种异体移植排斥反应常用的药物。虽然已有关于MMF相关性结肠炎弥漫性结肠炎的描述，但节段性结肠炎尚未见报道。我们报告了1例接受MMF治疗的64岁男性，因发热性腹泻和腹痛前来评估。乙状结肠镜检查发现乙状结肠、降结肠、脾曲和近端横结肠有节段性红斑黏膜伴溃疡。这些部位的活检显示隐窝扩张受损、嗜酸性上皮改变以及伴有凋亡小体的隐窝脓肿，符合MMF诱导的损伤。停用MMF后，他的症状显著改善。
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