Reversible chronic pulmonary fibrosis associated with MMF in a pediatric patient: A case report

Reynolds, B. C.; Paton, J Y; Howatson, Allan G.; Ramage, Ian

doi:10.1111/j.1399-3046.2007.00707.x

Cited by 9 publications

(3 citation statements)

References 13 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]. Postmarketing surveillance has also identified isolated reports of interstitial lung disease and pulmonary fibrosis in adult patients treated with MMF in combination with other immunosuppressants [9].…”

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

“…Common adverse effects (AEs) include gastrointestinal disturbance, myelosuppression and increased susceptibility to infection. Interstitial lung disease is a rare AE, and has been reported following solid organ transplants …”

mentioning

confidence: 99%

Reversible interstitial lung disease following treatment of atopic dermatitis with mycophenolate mofetil

2016

View full text Add to dashboard Cite

A 37-year-old woman with severe atopic dermatitis, was commenced on mycophenolate mofetil (MMF). Over the preceding 5 years she had been managed in our unit and treated with phototherapy, ciclosporin and azathioprine. MMF was started at an initial dose of 500 mg daily, and increased to 1 g twice daily with good clinical effect. However, 18 months into this treatment, the patient was noted to be short of breath with a dry cough and pleuritic chest pain. Serum autoimmune screen, hepatitis and human immunodeficiency virus serology were unremarkable, as were routine haematology and biochemistry. Serum IgA was slightly elevated at 3.8 g/L (normal range 0.6-3.10 g/L) but IgG and IgM were within the normal range.The patient was treated with oral amoxicillin 1 g three times daily and clarithromycin 500 mg twice daily.High-resolution computed tomography (CT) of the chest revealed bilateral ground-glass opacification, consistent with interstitial lung disease (Fig. 1). CT-pulmonary angiography demonstrated no evidence of pulmonary embolism.The patient was too hypoxic to undergo bronchoscopy. A lung biopsy was therefore taken using video-assisted thoracoscopic surgery. Histological examination revealed diffuse homogeneous expansion of the interstitium, with an infiltrate of lymphocytes and histiocytes. No granulomas or viral inclusion bodies were seen, and stains for acid-fast bacilli and Pneumocystis jirovecii were negative. Tissue culture from the specimen was negative, as were blood culture and serum precipitins. Owing to a dry cough, sputum was unobtainable, despite physiotherapy. Figure 1 High-resolution computed tomography of the chest demonstrating ground-glass opacification, consistent with interstitial lung disease. ª 2016 British Association of Dermatologists 702 Clinical and Experimental Dermatology (2016) 41, pp702-703 C P D A memorable patient T. J. Tull, T.

show abstract

“…In this issue, Reynolds et al. (1) describe a case of reversible chronic mineralizing pulmonary elastosis associated with mycophenolate mofetil (MMF) administration in a pediatric renal transplant recipient. In this case, a patient who underwent renal transplant at age five and a half yr because of renal failure related to treatment of Wilms’ tumor developed a cough unresponsive to antibiotic or beta agonist therapy at 14 months post‐transplant.…”

mentioning

confidence: 99%

Therapeutic idiosyncrasy

Sweet¹

2007

Pediatric Transplantation

View full text Add to dashboard Cite

Reversible chronic pulmonary fibrosis associated with MMF in a pediatric patient: A case report

Cited by 9 publications

References 13 publications

Paediatric use of mycophenolate mofetil

Paediatric use of mycophenolate mofetil

Reversible interstitial lung disease following treatment of atopic dermatitis with mycophenolate mofetil

Therapeutic idiosyncrasy

Contact Info

Product

Resources

About