Mycophenolate Mofetil and Clostridium difficile-associated Colitis

Abstract

Aim.A clinical observation of colitis conditioned by mycophenolate mofetil intake and concomitant Clostridium difficile-associated disease.Key points.Mycophenolate mofetil (MMF) is an active immunosuppressant with side effects affecting gastrointestinal tract (GIT). A 37-yo male patient with type 1 diabetes mellitus was admitted at a gastroenterology unit with clinical signs of diarrhoea with haematochezia. A history of diabetic nephropathy and related-donor pre-dialysis kidney transplantation in 2012, since when MMF intake was 2000 mg daily. Catarrhal ulcerative colitis in colonoscopy, C. difficile toxins in pathogen stool panel. Ulcerative, ischaemic colitises and the graft-versus-host disease were ruled out in examination. A positive clinical and endoscopic trend was observed upon MMF withdrawn and start of vancomycin.Conclusion.The case presented illustrates the clinical picture and diagnostic algorithm in MMF-associated colitis. The case-distinctive is association with C. difficile infection.