Background and Aims

Mycophenolate mofetil (MMF) is an immunosuppressive agent that exerts relatively selective antiproliferative effects on T and B lymphocytes.

The side effect profile of mycophenolate mofetil is generally at least as good as those of most immunomodulatory agents used in autoinmmune diseases.

Gastrointestinal symptoms and dose-related bone marrow suppression are the most commonly observed adverse effects, but these usually resolve with dose adjustments.

Methods

CASE REPORT :

A case of a 65 year old patient with a history of Raynaud’s phenomenon and overlap syndrome (1/1200 FAN, antiKU+) with pulmonary involvement NSIP initiates drug treatment with 40 mg of prednisone and 2000 mg/day MMF. After 7 months of treatment, the patient comes to the guard for presenting febrile syndrome of 2 days of evolution, diarrhea and marked weight loss.

The admission laboratory: Hypogammaglobulinemia 0.15.Lymphopenia.IgA: 10- IgG <200, IgM 20.Absolute value of CD 4 70, CD8 107.HBV, HIV,HCV- CMV IgM +IgG. Charge CMV: 5353.

A diagnosis of CMV colitis was made and which was confirmed by endoscopic biopsy.

She was treated with 3 weeks course of Valganciclovir with excellent response.It evolves with a good response, recovering the deficit in cellular immunity, requiring Gg EV after 3 months.

Results

DISCUSSION:Is mycophenolate a drug capable of generating alteration of cellular and humoral immunity?

Conclusions

The reported cases of alteration of cellular and humoral immunity by mycophenolate were very low.Only 3 cases were reported (Boddana 2011; Keven 2003; Robertson 2009).It is a very rare adverse effect. The purpose of this report is to highlight a potentially significant immune dysfunction following Mycophenolate therapy.