Microscopic features associated with mycophenolate mofetil in gastric and colonic biopsies

摘要

Sir. Mycophenolate mofetil (MMF) is an immunosup-pressive drug, used in the setting of transplantation and in the treatment of autoimmune disease, that is absorbed in the stomach and small intestine.1 It is associated with gastrointestinal toxicity, the clinico-pathological effects of which have been well documented in the clinical literature, and ascribed to the local toxicity of the drug.1 However, recent publications in the pathology literature have attributed these effects to the consequences of both local (in the case of upper gastrointestinal tract) and systemic (in the case of lower gastrointestinal tract) effects of MMF.2'3 We observed similar features in a recent series of gastric and colonic biopsies from the same patient, prompting us to review the pathology of 10 patients who underwent gastrointestinal biopsies at the Royal Liverpool University Hospital and who were treated with MMF.