Mycophenolate mofetil-induced liver injury in a patient with aquaporin-4 antibody positive transverse myelitis
- Resource Type
- Authors
- William Gelson; Arun K. Iyer; Susan E. Davies; Madeleine Frank
- Source
- BMJ Case Rep
- Subject
- medicine.medical_specialty
Biopsy
Case Report
Myelitis, Transverse
Mycophenolate
Gastroenterology
Transverse myelitis
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Alanine aminotransferase
Autoantibodies
Aquaporin 4
Liver injury
medicine.diagnostic_test
Drug Substitution
business.industry
Alanine Transaminase
General Medicine
Middle Aged
Mycophenolic Acid
medicine.disease
Liver
Aquaporin-4 antibody
Chemical and Drug Induced Liver Injury, Chronic
Liver biopsy
Transaminitis
Female
030211 gastroenterology & hepatology
Rituximab
business
Immunosuppressive Agents
030217 neurology & neurosurgery
- Language
- ISSN
- 1757-790X
We present a case of a 49-year-old woman diagnosed with aquaporin-4 antibody-positive transverse myelitis, who developed a significant transaminitis 2 months after commencing mycophenolate mofetil (MMF) as a steroid-sparing agent. No other risk factors were identified, a blood liver panel was negative and liver biopsy showed features compatible with drug-induced liver injury (DILI). MMF was stopped with a corresponding normalisation of serum alanine aminotransferase over the next 2 months. This case highlights MMF as a rare cause of DILI and provides justification for monitoring of liver biochemistry on therapy.