Journal of Pathology and Translational Medicine

Case Report

Mycophenolate Mofetil-Related Colitis: A Case Report.: Kyungeun Kim, Jerad M Gardner, Mary Schwartz, Matthew L Tompson, Jae Y Ro; Korean J Pathol. 2010;44(3):333-337.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.333

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Mycophenolate mofetil (MMF)-related colitis is one of the common causes of afebrile diarrhea in transplant patients. Pathologic diagnosis of MMF-related colitis is difficult because microscopic findings of MMF effects resemble those of graft-versus-host disease, inflammatory bowel disease and ischemic colitis. However, if diagnosed, MMF-induced colitis can be markedly improved by discontinuing the drug. A 70-year-old man having a history of transplantation presented with a one month history of afebrile diarrhea. Colonoscopy revealed patchy erosions. The colonoscopic biopsy specimen showed not only crypt disarray with degenerated crypts and scattered epithelial cell apoptosis, but also stromal inflammatory cell infiltration. A review of his medical records showed that he had been taking immunosuppressive drugs including MMF since his heart transplantation 6 years prior. The histologic findings of colonic mucosa were consistent with MMF-related colitis. After discontinuing MMF, the diarrhea quickly resolved and has not recurred for 10 months.

Citations

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Colitis eosinofílica inducida por micofenolato: reporte de caso
Mario Alberto Caviedes-Cleves, Ariel Antonio Arteta-Cueto
Iatreia.2023;[Epub] CrossRef
Mycophenolate Mofetil-Induced Colonic Injury Manifesting Endoscopically As Ischemic Colitis
Clive J Miranda, Murad H Ali, Muddasir Ayaz, Raheel M Khan, Mayada Ismail
Cureus.2023;[Epub] CrossRef
Transformation of the Amino Acid Pool in the Rat Brain under Conditions of Experimental Immunodeficiency
N. I. Filina, M. N. Kurbat
Neurochemical Journal.2022; 16(2): 174. CrossRef
A Case Series of De Novo Inflammatory Bowel Disease After Kidney Transplantation
P. Azevedo, C. Freitas, P. Aguiar, H. Silva, T. Santos, P. Farrajota, M. Almeida, S. Pedroso, L.S. Martins, L. Dias, R. Vizcaíno, A. Castro Henriques, A. Cabrita
Transplantation Proceedings.2013; 45(3): 1084. CrossRef

Original Article

Microscopic Colitis: The Pathologic Features of 24 Korean Patients.: Sun Ah Lee, Min Jung Kang, Sung Ae Jung, Heasoo Koo; Korean J Pathol. 2009;43(2):133-138.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.133

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Abstract PDF

BACKGROUND
The clinical presentation of microscopic colitis (MC) consists of chronic non-bloody watery diarrhea for weeks or months at a time, abdominal pain, and changes in bowel habits with a normal mucosal appearance upon performing colonoscopy. MC includes two relatively well established histopathologic entities: collagenous colitis (CC) and lymphocytic colitis (LC) as well as atypical forms. The recognition of the microscopic findings of this heterogeneous entity is very important for making the correct diagnosis and providing proper treatment.
METHODS
We studied the colonoscopic biopsy specimens that were obtained from 26 patients who had clinical findings that were suggestive of MC.
RESULTS
Fifteen patients (M:F=9:6) and 9 patients (M:F=5:4) showed the microscopic features of LC and MC, not otherwise specified, respectively.
CONCLUSIONS
The clinicopathologic findings (the incidence of the subtypes, the patients' ages and the male/female ratio) of the 24 cases of MC in this study showed differences from the previously reported findings from other countries. Further studies with a sufficient number of patients from multi-centers would be necessary to confirm the regional or ethnic influence.

Citations

Citations to this article as recorded by

A Case of Methicillin-Resistant Staphylococcal Enterocolitis with Subsequent Development of Lymphocytic Colitis
Joong Ho Bae, Dong Soo Han, Hye Sun Park, Yil Sik Hyun, Tae Yeob Kim, Chang Soo Eun, Yong Cheol Jeon, Joo Hyun Sohn
Intestinal Research.2011; 9(2): 139. CrossRef

Case Report

Pathologically Diagnosed Giardia Lamblia Enteritis: A case report.: An Hi Lee, Kyoung Mee Kim, Se Hyun Cho, Sang In Shim; Korean J Pathol. 1996;30(4):361-363.

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Abstract PDF: Giardiasis is one of the most common causes of infectious diarrhea and it has a worldwide distribution. Although it is a relatively common disorder, histologically confirmed Giardiasis is a rare occurrence and there have been no previous reports in Korea. A 34-year-old man presented with a 2-year history of epigastric discomfort and left flank pain. On stool examination, many cystic forms of Giardia lamblia were noted. In biopsy specimens of the small intestine, there was moderate chronic inflammatory cell infiltration and several trophozoites of Giardia were observed in the intervillous space and luminal surface. The trophozoites were pear shaped symmetrical organisms with two nuclei, and measured 9~10 micrometer in length.

Original Article

Microvillous Inclusion Disease: An analysis of 4 cases.: Daesu Kim, Nam Seon Beck, Yeon Lim Suh; Korean J Pathol. 2000;34(3):208-213.

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Abstract PDF: Microvillous inclusion disease (MID) or congenital microvillous atrophy is a rare cause of intractable, persistent secretory diarrhea shortly after birth or at birth. The prognosis of MID is very poor and most of the reported patients have died within 6.5 years. Diagnosis is based on the ultrastructural demonstration of intracytoplasmic inclusion of microvilli. There have been several cases reported in the literature. To evaluate the clinicopathologic features of MID, we have reviewed 4 cases of MID which was confirmed by the ultrastructural study of the duodenal biopsy. All patients suffered from life-threatening diarrhea since birth. Many other radiologic or laboratory findings were of no value in the evaluation of causative agents. One of the patients died of the disease and remaining patients have been alive on intravenous fluids or total parenteral nutrition. Histological findings of all cases were similar and characterized by varying degrees of mucosal atrophy and chronic inflammatory cell infiltration in the duodenal mucosa. PAS stain revealed a discontinuous brush border over the atrophic villous surface with or without small vacuoles in the cytoplasm of the surface epithelium. Ultrastructural changes were found mainly in the surface epithelium of the duodenal mucosa and characterized by the presence of membrane bound inclusions lined by intact or degenerating microvilli, as well as degeneration of surface epithelial cells with loss of microvilli, or with sparse, short microvilli.

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