Open AccessMycophenolate‐Induced Colitis in Autoimmune Polyendocrinopathy‐Candidiasis‐Ectodermal Dystrophy Patients
Author(s) -
Schmitt Monica M.,
Ferré Elise M. N.,
Sampaio De Melo Michelly,
Cooper Megan A.,
Quezado Martha M.,
Heller Theo,
Lionakis Michail S.
Publication year - 2021
Publication title -
jpgn reports
Language(s) - English
Resource type - Journals
ISSN - 2691-171X
DOI - 10.1097/pg9.0000000000000131
Subject(s) - medicine , mycophenolate , colitis , autoimmune disease , gastroenterology , immunology , autoimmunity , dystrophy , inflammatory bowel disease , dermatology , mycophenolic acid , disease , pathology , transplantation
Introduction: Autoimmune polyendocrinopathy‐candidiasis‐ectodermal dystrophy (APECED) is a prototypic monogenic autoimmune disorder caused by AIRE deficiency‐mediated impaired central immune tolerance. Although multiple endocrine and nonendocrine tissues are affected in APECED, the colon is an uncommon target of autoimmune attack. Mycophenolate is a potent immunomodulatory medication that is used to treat autoimmune manifestations in patients with APECED and other autoimmune diseases. Methods: We reviewed the clinical, laboratory, genetic, histological, and treatment data of mycophenolate‐induced colitis in our cohort of 104 APECED patients. Results: Among 10 mycophenolate‐treated APECED patients, 4 (40%) developed reversible biopsy‐proven mycophenolate‐induced colitis characterized by an inflammatory bowel disease‐like and/or graft‐versus‐host disease‐like histological pattern. Conclusion: Mycophenolate‐induced colitis appears to be a common complication in patients with APECED for which clinicians should maintain a high index of suspicion.