Oral Ulcerations in a Renal Transplant Recipient: A Mycophenolate Mofetil-Induced Complication?

Oral ulcers in kidney transplant recipients treated with sirolimus and mycophenolate mofetil

“…Also, in a randomized trial of MMF in kidney transplant patients treated with a tacrolimus-based regimen, the incidence of oral ulcerations was not mentioned at all (9). Nevertheless, some authors have reported severe oral ulcerations suggested to be attributable to MMF toxicity (10). Patients in the authors' study had been on MMF treatment for 1 year and did not suffer from oral ulcerations at the time of initiation of sirolimus treatment.…”

Mycophenolate mofetil in dermatology

“…While tolerable GI upset is relatively common, rare GI side effects include oral ulcerations, GI hemorrhage, esophagitis, gastritis, duodentitis, villous atrophy, and ischemic colitis. [115][116][117][118] Uncommon cutaneous side effects include generalized urticaria, dishydrotic eczema, blistering hand dermatitis, and onycholysis. 48,119,120 Although MMF is generally accepted as having a low risk of hepatotoxicity, there are published cases of MMF-induced elevated hepatic transaminases and hyperbilirubinemia.…”

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“…3 However, the use of mycophenolate mofetil may be accompanied by some general gastrointestinal adverse effects, including nausea, vomiting, cramps, and even constipation, but some more serious complications may also appear, such as gastrointestinal hemorrhage, esophagitis, gastritis, duodenitis, atrophic villus, colitis, and oral ulcers. 4 In our patient, because of the painful and irritating nature of oral ulcers suspected as a mycophenolate mofetil adverse effect,…”