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Case Reports in Pediatrics
Volume 2012 (2012), Article ID 624168, 5 pages
http://dx.doi.org/10.1155/2012/624168
Case Report

Mycophenolate Mofetil-Related Enterocolitis and Weight Loss: A Pediatric Case Series

1Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children’s, 3333 Burnet Avenue MLC 2010, Cincinnati, OH 45229-3039, USA
2Division of Gastroenterology, University of Southern California, 4650 Sunset Boulevard, MS #126, Los Angeles, CA 90027, USA
3Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children's Way, 11th Floor, Doctors' Office Tower, Nashville, TN 37232-2576, USA
4Seacoast Pathology, Aurora Diagnostics, 1 Hampton Road, Suite 208, Exeter, NH 03833-4849, USA
5Division of Gastroenterology, Oschner Children’s Health Center, 1315 Jefferson Highway, New Orleans, LA 70121, USA
6Division of Pediatric Gastroenterology and Nutrition Sciences, University of Alabama at Birmingham, 1600 7th Avenue. S., Lowder Blgd., Ste. 618, Birmingham, AL 35233, USA
7Department of Nephrology, University of Minnesota, Pediatric Specialty Care Discovery Clinic, 2512 Building, 2512 S. 7th Street, Minneapolis, MN 55454, USA
8Division of Pediatric Nephrology, Vanderbilt University School of Medicine, 2200 Children's Way, 11th Floor, Doctors' Office Tower, Nashville, TN 37232, USA
9Department of Pathology, University of Arizona, 1501 N. Campbell Avenue, P.O. Box 245108, Tucson, AZ 85724-5108, USA

Received 10 August 2012; Accepted 6 September 2012

Academic Editors: E. Czkwianianc, A. W. Kamps, and D. I. Zafeiriou

Copyright © 2012 Dana M. H. Dykes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mycophenolate mofetil (MMF) is an immunosuppressive medication utilized in the management of both autoimmune and solid organ transplant patients. Diarrhea is a common gastrointestinal side effect of MMF, but more severe forms of GI symptoms are described in renal transplant patients with a distinct pattern of histopathologic change, similar to graft-versus-host disease or Crohn’s disease. This rare entity, commonly referred to as “MMF-related enterocolitis,” has been described in adult patients, mostly in renal transplant patients, and in only two pediatric renal transplant patients. In previously reported cases, symptoms and abnormal histopathology improve with dose reduction of MMF. We describe a series of three pediatric patients with varied underlying disease process who presented with severe diarrhea and histopathologic findings characteristic of MMF-related enterocolitis, who share a novel finding of weight loss as a complication of MMF-related enterocolitis in pediatric patients.