Reversible abnormal chromatin clumping in granulocytes from six transplant patients treated with mycophenolate mofetil: a rare adverse effect mimicking abnormal chromatin clumping syndrome

Daliphard, Sylvie; Accard, Françoise; Delattre, Carole; Toupance, Olivier; Guyot, C.; Méchinaud, Françoise; Chassaing, Anne; Hourmant, Maryvonne; Rousset, Pascal; Potron, G

doi:10.1046/j.1365-2141.2002.3317_2.x

Cited by 7 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some less common adverse effects have been reported in children, as follows: an abnormal chromatin clumping syndrome in two children associated with leucocytosis [65]; pseudotumour cerebri syndrome in a 5‐year‐old child taking MMF for autoimmune lymphoproliferative disease [66]; and two cases of children with severe colitis [67]. Perhaps the most significant, albeit rare, adverse effects have been due to respiratory problems, including a single case of reversible chronic mineralizing pulmonary elastosis in a 7‐year‐old boy [68] and several instances of bronchiectasis [69, 70].…”

Section: Unresolved Issues With the Use Of Mmf In Childrenmentioning

confidence: 99%

Paediatric use of mycophenolate mofetil

Downing

Pirmohamed

Beresford

et al. 2012

Brit J Clinical Pharma

View full text Add to dashboard Cite

A number of medications do not have a licence, or label, for use in the paediatric age group nor for the specific indication for which they are being used in children. Over recent years, mycophenolate mofetil has increasingly been used off‐label (i.e. off‐licence) in adults for a number of indications, including autoimmune conditions; progressively, this wider use has been extended to children. This review summarizes current use of mycophenolate mofetil (MMF) in children, looking at how MMF works, the pharmacokinetics, the clinical conditions for which it is used, the advantages it has when compared with other immunosuppressants and the unresolved issues remaining with use in children. The review aims to focus on off‐label use in children so as to identify areas that require further research and investigation. The overall commercial value of MMF is limited because it has now come off patent in adults. Given the increasing knowledge of the pharmacodynamics, pharmacokinetics and pharmacogenomics demonstrating the clinical benefits of MMF, new, formal, investigator‐led studies, including trials focusing on the use of MMF in children, would be of immense value.

show abstract

Section: Unresolved Issues With the Use Of Mmf In Childrenmentioning

confidence: 99%

Paediatric use of mycophenolate mofetil

Downing

Pirmohamed

Beresford

et al. 2012

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…The mechanism of the appearance of ACC is debated although the direct toxic effect of mycophenolate mofetil is one of the hypotheses. In five patients ACC disappeared after tapering or discontinuation of mycophenolate mofetil, confirming that ACC was transient and dose-dependent [ 6 ]. ACC has also been described due to an alteration of the immune status.…”

Section: Discussionmentioning

confidence: 89%

Abnormal Chromatin Clumping in Myeloblasts Mimicking Chronic Lymphocytic Leukaemia: A Diagnostic Pitfall

Sehgal¹,

Gaur²,

Kumar³

et al. 2021

Cureus

View full text Add to dashboard Cite

Abnormal chromatin clumping (ACC) in cells of myeloid lineage is a distinct morphological entity. It has been described mainly in polymorphs in haematological neoplasms involving myelodysplasia or myeloproliferation. We here describe a rare case of ACC in myeloblasts in an elderly man that mimicked chronic lymphocytic leukaemia. Flow cytometry played a crucial role in characterizing the myeloid lineage of the blasts, thus avoiding a misdiagnosis. To the best of our knowledge, this is the third time such a case has been reported in the literature.

show abstract

“…Acquired Pelger-Huët anomaly, also known as pseudo–Pelger-Huët anomaly, has morphological features that resemble the congenital anomaly. 15 The acquired anomaly is sporadic, but has been observed in human patients with hematological diseases such as myelodysplastic syndrome, 27,29 and has been associated with the administration of drugs such as sulfisoxazole, 13 sulfadiazine–trimethoprim, 28 valproate, 21 taxoid, 12 immunosuppressive agents, 4,6,9 and ibuprofen. 23 Acquired Pelger-Huët anomaly has also been associated with infections and inflammatory diseases in human beings 5 and animals.…”

mentioning

confidence: 99%

Pelger-Huët anomaly in two related mixed-breed dogs

et al. 2011

View full text Add to dashboard Cite

A 6-month-old male mixed-breed dog weighing 12.6 kg weight was presented for evaluation of a subcutaneous nodule on the dorsum. The medical history indicated trimethoprim-sulfamethoxazole treatment 2 months before presentation at the veterinary hospital. The initial complete blood cell count (CBC) results included an apparent left shift. Microscopic examination of a blood smear (Panoptic stain) revealed granulocytes with hyposegmented nuclei, coarse mature chromatin, and a nuclear shape varying from round to bilobed (pince-nez) or slightly indented. Occasional neutrophils and eosinophils had typical segmentation of nuclei. Abnormalities were not present in limited serum biochemical testing. The CBC was repeated 17 and 120 days later, and the results were similar to those observed in the first examination. The parents of the patient were located, and a CBC was performed on both animals. The dam, but not the sire, had nuclear hyposegmentation of granulocytes, confirming the diagnosis of Pelger-Huët anomaly.

show abstract

Reversible abnormal chromatin clumping in granulocytes from six transplant patients treated with mycophenolate mofetil: a rare adverse effect mimicking abnormal chromatin clumping syndrome

Cited by 7 publications

References 4 publications

Paediatric use of mycophenolate mofetil

Paediatric use of mycophenolate mofetil

Abnormal Chromatin Clumping in Myeloblasts Mimicking Chronic Lymphocytic Leukaemia: A Diagnostic Pitfall

Pelger-Huët anomaly in two related mixed-breed dogs

Contact Info

Product

Resources

About