mycophenolic-acid and Chemical-and-Drug-Induced-Liver-Injury--Chronic

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.

Topics: Alanine Transaminase; Aquaporin 4; Autoantibodies; Biopsy; Chemical and Drug Induced Liver Injury, Chronic; Drug Substitution; Female; Humans; Immunosuppressive Agents; Liver; Middle Aged; Mycophenolic Acid; Myelitis, Transverse; Rituximab