{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T07:19:48Z","timestamp":1696403988245},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:00:00Z","timestamp":1421798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Diarrhoea following orthotopic liver transplantation (<jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content>) is a significant clinical problem associated with mycophenolic acid (<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>). The histological injury pattern associated with <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> in the large bowel is well documented in the literature; however, that in the duodenum is less extensively documented. The aim of this study was to investigate the histological spectrum of duodenal injury specifically in symptomatic <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> patients on <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>, and to compare this with the spectrum in patients with coeliac disease and in normal controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We reviewed our pathology database for all duodenal biopsies from patients on the <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> list over a period of 19\u00a0years. Medical records, anti\u2010tissue transglutaminase IgA serology and histology were reviewed. Of the 667 patients who underwent endoscopy, 127 had duodenal biopsies (152 biopsies). Of these, 87.5% were normal. Sixteen showed abnormal histology, and seven (43.8%) of these were on <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> at the time of biopsy. Significant features included coeliac\u2010like changes (shortened villi and increased intraepithelial lymphocyte counts), and novel findings included increased endocrine cell counts, apoptotic counts and lamina propria eosinophil counts in comparison with normal duodenal biopsies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pathologists should be aware of the features of <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>\u2010associated duodenal injury, including coeliac\u2010like changes and increased apoptotic counts. In those with abnormal histology, discontinuation or a reduction in the dose of <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> should be discussed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12541","type":"journal-article","created":{"date-parts":[[2014,9,6]],"date-time":"2014-09-06T07:21:43Z","timestamp":1409988103000},"page":"500-507","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Coeliac\u2010like duodenal pathology in orthotopic liver transplant patients on mycophenolic acid therapy"],"prefix":"10.1111","volume":"66","author":[{"given":"Maura B","family":"Cotter","sequence":"first","affiliation":[{"name":"Department of Histopathology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"AbuShanab","sequence":"additional","affiliation":[{"name":"Department of Hepatology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Merriman","sequence":"additional","affiliation":[{"name":"Department of Hepatology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiden","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Hepatology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran","family":"Sheahan","sequence":"additional","affiliation":[{"name":"Department of Histopathology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"},{"name":"Department of Hepatology Centre for Colorectal Disease St Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20500"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2001.23356"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00556.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20210"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.107792"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03423.x"},{"key":"e_1_2_8_8_1","first-page":"139","article-title":"Mycophenolate mofetil: safety and efficacy in the prophylaxis of acute kidney transplantation rejection","volume":"5","author":"Dalal P","year":"2009","journal-title":"Ther. 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