, Volume 29, Issue 12, pp 1529-1530

Early onset neutropenia after mycophenolate mofetil in systemic sclerosis

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Mycophenolate mofetil (MMF), by inhibiting the de novo synthesis of purines, displays potent immunosuppressive properties on B and T lymphocytes and is now widely used in transplant medicine [1, 2] and lupus nephritis [3, 4]. Moreover, MMF inhibits the proliferation of vascular smooth muscle cells [5] and fibroblasts [6], thereby suggesting that the drug might be effective in diseases such a scleroderma [79], in which fibrotic process are prominent.

In this report, we describe a case of early onset neutropenia after MMF therapy in systemic sclerosis (SSc).

A 63-year-old white woman was diagnosed, 7 years ago, as having SSc. Disease duration, from Raynaud’s phenomenon, is 20 years. In 2000, the patients developed scleredema; 2001 skin sclerosis, weight loss, dysphagia; 2003 alveolitis; 2006 heart failure. Concomitant diseases: hypertension, nodular goiter, osteoporosis. Remission of alveolitis was achieved with steroids and cyclophosphamide in 2003.

New onset of alveolitis appeared in Jan