A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis

We report a rare case of a severe maculopapular rash following the initiation of mycophenolate mofetil MMF in a 13-year-old female adolescent who was diagnosed with systemic lupus erythematosus SLE and stage...

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Main Authors: Rubiya M, Sahana Devadas, Sujatha P, Dakshayani B
Format: Article
Language:English
Published: Rajiv Gandhi University of Health Sciences 2025-01-01
Series:RGUHS Journal of Medical Sciences
Online Access: https://journalgrid.com/view/article/rjms/12434457
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author Rubiya M
Sahana Devadas
Sujatha P
Dakshayani B
author_facet Rubiya M
Sahana Devadas
Sujatha P
Dakshayani B
author_sort Rubiya M
collection DOAJ
description We report a rare case of a severe maculopapular rash following the initiation of mycophenolate mofetil MMF in a 13-year-old female adolescent who was diagnosed with systemic lupus erythematosus SLE and stage IV lupus nephritis. MMF an effective immunosuppressive agent selectively inhibits T and B lymphocyte proliferation and is known for its rapid onset and relatively mild side effect profile compared to other immunosuppressants. The patient was initially treated with intravenous and oral prednisolone along with hydroxychloroquine followed by introduction of mycophenolate mofetil two days later. Within 24 hours of starting MMF she developed an adverse event characterized by a maculopapular rash with blisters intense itching facial puffiness and swelling of the lips. High-dose steroids and discontinuation of MMF led to gradual improvement with complete resolution of symptoms within two days. The diagnosis of a druginduced eruption was supported by symptom resolution and a marked response to steroids. While common side effects of MMF include gastrointestinal disturbances and peripheral oedema severe skin reactions are infrequent. Given the overall prevalence of MMF use we present a rare case of generalised maculopapular rash caused by MMF. This case highlights the adverse event caused by MMF in the context of SLE and lupus nephritis underscoring the need for vigilant monitoring of patients receiving this treatment.
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institution Kabale University
issn 2231-1947
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publishDate 2025-01-01
publisher Rajiv Gandhi University of Health Sciences
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spelling doaj-art-e1d5bf0f87b74bd4baa5659d4c75f8472025-08-20T03:41:53ZengRajiv Gandhi University of Health SciencesRGUHS Journal of Medical Sciences2231-19472581-72482025-01-0115310.26463/rjms.15_3_2A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus NephritisRubiya MSahana DevadasSujatha PDakshayani B We report a rare case of a severe maculopapular rash following the initiation of mycophenolate mofetil MMF in a 13-year-old female adolescent who was diagnosed with systemic lupus erythematosus SLE and stage IV lupus nephritis. MMF an effective immunosuppressive agent selectively inhibits T and B lymphocyte proliferation and is known for its rapid onset and relatively mild side effect profile compared to other immunosuppressants. The patient was initially treated with intravenous and oral prednisolone along with hydroxychloroquine followed by introduction of mycophenolate mofetil two days later. Within 24 hours of starting MMF she developed an adverse event characterized by a maculopapular rash with blisters intense itching facial puffiness and swelling of the lips. High-dose steroids and discontinuation of MMF led to gradual improvement with complete resolution of symptoms within two days. The diagnosis of a druginduced eruption was supported by symptom resolution and a marked response to steroids. While common side effects of MMF include gastrointestinal disturbances and peripheral oedema severe skin reactions are infrequent. Given the overall prevalence of MMF use we present a rare case of generalised maculopapular rash caused by MMF. This case highlights the adverse event caused by MMF in the context of SLE and lupus nephritis underscoring the need for vigilant monitoring of patients receiving this treatment. https://journalgrid.com/view/article/rjms/12434457
spellingShingle Rubiya M
Sahana Devadas
Sujatha P
Dakshayani B
A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
RGUHS Journal of Medical Sciences
title A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
title_full A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
title_fullStr A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
title_full_unstemmed A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
title_short A Rare Case of Severe Skin Reaction to Mycophenolate Mofetil in Systemic Lupus Erythematosus with Lupus Nephritis
title_sort rare case of severe skin reaction to mycophenolate mofetil in systemic lupus erythematosus with lupus nephritis
url https://journalgrid.com/view/article/rjms/12434457
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