{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:28:50Z","timestamp":1792056530952,"version":"4.4.0"},"reference-count":18,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,21]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2020-238345","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e238345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Mycophenolate mofetil-induced liver injury in a patient with aquaporin-4 antibody positive transverse myelitis"],"prefix":"10.1136","volume":"13","author":[{"given":"Arun","family":"Iyer","sequence":"first","affiliation":[{"name":"Hepatology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Frank","sequence":"additional","affiliation":[{"name":"Hepatology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Davies","sequence":"additional","affiliation":[{"name":"Hepatology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T","family":"Gelson","sequence":"additional","affiliation":[{"name":"Hepatology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"2025082804405504000_13.12.e238345.1","first-page":"167","article-title":"Transverse myelitis--a review of the presentation, diagnosis, and initial management","volume":"16","author":"West","year":"2013","journal-title":"Discov Med"},{"key":"2025082804405504000_13.12.e238345.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.31.8.966"},{"key":"2025082804405504000_13.12.e238345.3","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540050074019"},{"key":"2025082804405504000_13.12.e238345.4","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.19-2-169"},{"key":"2025082804405504000_13.12.e238345.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.4.499"},{"key":"2025082804405504000_13.12.e238345.6","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31823dc535"},{"key":"2025082804405504000_13.12.e238345.7","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-199512000-00023"},{"key":"2025082804405504000_13.12.e238345.8","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1080\/08860220500200171","article-title":"Uncommon side effect of MMF in renal transplant recipients","volume":"27","author":"Balal","year":"2005","journal-title":"Ren Fail"},{"key":"2025082804405504000_13.12.e238345.9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.00288"},{"key":"2025082804405504000_13.12.e238345.10","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2009.175"},{"key":"2025082804405504000_13.12.e238345.11","doi-asserted-by":"crossref","DOI":"10.1097\/01.tp.0000231873.86048.68","article-title":"Mycophenolate sodium-induced hepatotoxicity: first report","volume":"82","author":"Loupy","year":"2006","journal-title":"Transplantation"},{"key":"2025082804405504000_13.12.e238345.12","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.nefro.2019.02.009","article-title":"Mycophenolate sodium-induced hepatotoxicity: the second report?","volume":"39","author":"Moreiras-Plaza","year":"2019","journal-title":"Nefrologia"},{"key":"2025082804405504000_13.12.e238345.13","unstructured":"NIDDK . LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. In: Mycophenolat. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 2012. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548945\/"},{"key":"2025082804405504000_13.12.e238345.14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/DER.0000000000000074","article-title":"Hepatitis due to mycophenolate mofetil used to treat atopic dermatitis and allergic contact dermatitis","volume":"25","author":"Nguyen","year":"2014","journal-title":"Dermatitis"},{"key":"2025082804405504000_13.12.e238345.15","first-page":"300","article-title":"H\u00e9patite a\u00efgue apr\u00e8s prise de mycoph\u00e9nolate mof\u00e9til","volume":"26","author":"Corrieri-Baizeau","year":"2002","journal-title":"Gastroenterol Clin Biol"},{"key":"2025082804405504000_13.12.e238345.16","doi-asserted-by":"crossref","first-page":"10715","DOI":"10.3748\/wjg.v20.i31.10715","article-title":"Clinical mycophenolic acid monitoring in liver transplant recipients","volume":"20","author":"Chen","year":"2014","journal-title":"World J Gastroenterol"},{"key":"2025082804405504000_13.12.e238345.17","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jceh.2014.05.003","article-title":"Role of mycophenolate mofetil for the treatment of autoimmune hepatitis-an observational study","volume":"4","author":"Jothimani","year":"2014","journal-title":"J Clin Exp Hepatol"},{"key":"2025082804405504000_13.12.e238345.18","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1093\/rheumatology\/kew479","article-title":"BSR and BHPR guideline for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs","volume":"56","author":"Ledingham","year":"2017","journal-title":"Rheumatology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:41:05Z","timestamp":1756381265000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":18,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,22]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bcr-2020-238345"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238345","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}