Correlation of abnormal histology with endoscopic findings among mycophenolate mofetil treated patients

作     者：Mitchell A Izower Merajur Rahman Ernesto P Molmenti Madhu C Bhaskaran Viren G Amin Sundas Khan Keith Sultan 

作者机构：Department of MedicineNorth Shore University Hospital Division of GastroenterologyDepartment of MedicineNorth Shore University Hospital Department of SurgeryNorth Shore University Hospital Divison of NephrologyDepartment of MedicineNorth Shore University Hospital the Feinstein Institute for Biomedical Research 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第8期

页      面：405-410页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Mycophenolate mofetil 大肠炎 Colonoscopy 腹泻 

摘      要：AIM To describe all abnormal histological findings and their associated endoscopic presentation in patients using mycophenolate mofetil(MMF).METHODS A retrospective review of all individuals prescribed MMF within 6 mo of a colonoscopy or flexible sigmoidoscopy between 07/2009 and 09/2015 was performed within Northwell Health *** were analyzed for age,gender,procedure indication,MMF indication,and both gross and microscopic *** reports with abnormal histology were *** One hundred and eighty-four procedures from 170 patients were found,of which 39 met inclusion ***-one point three percent were *** was used for solid organ transplant in 71.8%.Diarrhea was the indication for 71.8% of *** percent of reports revealed gross and microscopic abnormalities while 41.0% had only microscopic *** 11 patients reports(28.2%) indicated a specific histopathology of MMF *** the entire group,only 23.1% of abnormal histology was isolated proximal to the splenic *** Our results demonstrate a high rate of left sided disease and microscopic findings without gross mucosal abnormalities among patients using ***,a broader definition of MMF-colonopathy may be appropriate,with a majority of our abnormal histology falling outside of the more narrowly defined MMF-colitis *** the high frequency of isolated microscopic abnormalities and distal disease,sigmoidoscopy with random biopsies may be an appropriate,less invasive initial endoscopic examination in selected MMF patients.