Sonoda Akira, Wada Kurato, Mizukami Kazuhiro, Fukuda Kensuke, Shuto Mitsutaka, Okamoto Kazuhisa, Ogawa Ryo, Okimoto Tadayoshi, Murakami Kazunari
Department of Gastroenterology, Oita University, Japan.
Intern Med. 2017 Nov 1;56(21):2883-2886. doi: 10.2169/internalmedicine.8815-17. Epub 2017 Sep 25.
A 54-year-old man was treated with mycophenolate mofetil (MMF) after undergoing living donor renal transplantation. Two years later, he experienced repeated episodes of diarrhea, and his C-reactive protein (CRP) level was found to be 12.63 mg/dL. Ileocolonoscopy showed multiple deep, punched-out ulcers that were similar to Behçet's disease (BD) and cytomegalovirus (CMV) in the ileum. CMV infection was suspected. However, anti-cytomegalovirus agents were ineffective. The patient was subsequently diagnosed with gastrointestinal toxicity of MMF and MMF was switched to mizoribine. His symptoms improved immediately, and his CRP level normalized. Six months later, the patient's mucosa was healed.
一名54岁男性在接受活体供肾移植后接受了霉酚酸酯（MMF）治疗。两年后，他反复出现腹泻，C反应蛋白（CRP）水平为12.63mg/dL。回结肠镜检查显示在回肠有多个类似于白塞病（BD）和巨细胞病毒（CMV）感染的深的、凿孔样溃疡。怀疑有CMV感染。然而，抗巨细胞病毒药物治疗无效。该患者随后被诊断为MMF的胃肠道毒性，MMF被换为咪唑立宾。他的症状立即改善，CRP水平恢复正常。6个月后，患者的黏膜愈合。
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