Reviewing the evidence for mycophenolate mofetil as a new teratogen: Case report and review of the literature

American Journal of Medical Genetics, Part A

Volumn 149, Issue 6, 2009, Pages 1241-1248

  Anderka, Marlene T ^a   Lin, Angela E ^a,b   Abuelo, Dianne N ^c,d,e   Mitchell, Allen A ^f   Rasmussen, Sonja A ^g  

^a MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH   (United States)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

^c RHODE ISLAND HOSPITAL   (United States)

^d HASBRO CHILDREN'S HOSPITAL   (United States)

^e BROWN UNIVERSITY   (United States)

^f BOSTON UNIVERSITY   (United States)

^g CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

Author keywords

CellCept ; Cleft lip and palate; Coloboma; Malformation; Microtia; Mycophenolate mofetil; Teratogenesis

Indexed keywords

HYDROXYCHLOROQUINE; LISINOPRIL; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PREDNISONE;

ADULT; ANAMNESIS; ATRESIA; AUDITORY CANAL; CASE REPORT; CHILD; CHROMOSOME ANALYSIS; CLINICAL FEATURE; DNA MICROARRAY; ECHOGRAPHY; FEMALE; HEARING LOSS; HUMAN; INTRAUTERINE GROWTH RETARDATION; LUPUS ERYTHEMATOSUS NEPHRITIS; MALE; MALFORMATION SYNDROME; MICROCEPHALY; MICROTIA; PRENATAL EXPOSURE; PRIORITY JOURNAL; REVIEW; TERATOGENESIS;

ABNORMALITIES, DRUG-INDUCED; ABNORMALITIES, MULTIPLE; FATAL OUTCOME; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; MATERNAL-FETAL EXCHANGE; MYCOPHENOLIC ACID; PREGNANCY; TERATOGENS; YOUNG ADULT;

ORYCTOLAGUS CUNICULUS; RATTUS;

EID: 66349089572     PISSN: 15524825     EISSN: 15524833     Source Type: Journal    
DOI: 10.1002/ajmg.a.32685     Document Type: Review

References (43)

1. Allison AC, Eugui EM. 2000. Mycophenoloate mofetil and its mechanisms of action. Immunopharmacology 47:85-118. (Pubitemid 30394534)
2. Amiel J, Faivre L, Marianowski R, Bonnet D, Couly G, Manach Y, Le Merrer M, Cormier-Daire V, Munnich A, Lyonnet S. 2001. Hypertelorismmicrotia-clefting syndrome (Bixler syndrome): Report of two unrelated cases. Clin Dysmorphol 10:15-18. (Pubitemid 32047037)
3. Ang GS, Simpson SA, Reddy AR. 2008. Mycophenolate mofetil embryopathy may be dose and timing dependent. Am J Med Genet Part A 146A:1963-1966.
4. Armenti VT, Moritz MJ, Radomski JS, Gaughan WJ, Hecker WP, Lavelanet A, McGrory CH, Coscia LA. 2004. Report from the National Transplantation Pregnancy Registry (NTPR): Outcomes of Pregnancy After Transplantation. In: Cecka JM, Terasaki PI, editors. Clinical Transplants 2004. Los Angeles, CA: UCLA Immunogenetics Center. p 103-119.
5. Armenti VT, Moritz MJ, Radomski JS, Gaughan WJ, McGrory CH, Coscia LA. 2005. Report from the National Transplantation Pregnancy Registry (NTPR): Outcomes of Pregnancy After Transplantation. In: Cecka JM, Terasaki PI, editors. Clinical Transplants 2005. Los Angeles, CA: UCLA Immunogenetics Center. p 69-83.
6. Brent RL. 1993. Congenital malformation case reports: The editor's and reviewer's dilemma. Am J Med Genet 47:872-874. (Pubitemid 23317999)
7. Callen JP. 2001. Immunosuppressive and cytotoxic drugs in the treatment of rheumatic skin disorders. Semin Cutan Med Surg 20:58-68. (Pubitemid 32230278)
8. Carey JC. 2002. Editor's note. Am J Med Genet 111:54.
9. Carey JC. 2008. Where observation is concerned, chance favors only the prepared mind. Obstet Gynecol 111:479-480.
10. Carney EW, Scialli AR, Watson RE, DeSesso JM. 2004. Mechanisms regulating toxicant disposition to the embryo during early pregnancy. Birth Defects Res C Embryo Today 72:345-360.
11. Frieling U, Luger TA. 2002. Mycophenolate mofetil and leflunomide: Promising compounds for the treatment of skin diseases. Clin Exp Dermatol 27:562-570. (Pubitemid 35463872)
12. Gregoor PJHS, van Gelder T, Weimar W. 2000. Mycophenolate mofetil, Cellcept®, a new immunosuppressive drug with great potential in internal medicine. Neth J Med 57:233-246.
13. Hesselink DA, van Gelder T. 2005. Genetic and nongenetic determinants of between-patient variability in the pharmacokinetics of mycophenolic acid. Clin Pharmacol Ther 78:317-321. (Pubitemid 41393666)
14. Källén B, Westgren M, Aberg A, Otterblad Olausson P. 2005. Pregnancy outcome after maternal organ transplantation in Sweden. Br J Obstet Gynaecol 112:904-909. (Pubitemid 40896955)
15. Kaufman DB, Shapiro R, Lucey MR, Cherikh WS, Bustami RT, Dyke DB. 2004. Immunosuppression: Practice and trends. Am J Transplant 4:38-53. (Pubitemid 38858994)
16. Kennedy DL, Uhl K, Kweder SL. 2004. Pregnancy exposure registries. Drug Saf 27:215-228. (Pubitemid 38372902)
17. Lammer EJ. 1991. Preliminary observations on isotretinoin-induced ear malformations and pattern formation of the external ear. J Craniofac Genet Dev Biol 11:292-295.
18. Lammer EJ, Chen DT, Hoar RM, Agnish ND, Benke PJ, Braun JT, Currey CJ, Fernhoff PM, Grix AW, Lott IT, Richard JM, Sun SC. 1985. Retinoic acid embryopathy. N Engl J Med 313:837-841. (Pubitemid 15250197)
19. LeRay C, Coulomb A, Elefant E, Frydman R, Audibert F. 2004. Mycophenolate mofetil in pregnancy after renal transplantation: A case of major fetal malformations. Obstet Gynecol 103:1091-1094.
20. Liu V, Mackool BT. 2003. Mycophenolate in dermatology. J Dermatol Treat 14:203-210. (Pubitemid 37474529)
21. Lo WY, Friedman JM. 2002. Teratogenicity of recently introduced medications in human pregnancy. Obstet Gynecol 100:465-473. (Pubitemid 35246132)
22. Lynberg MC, Khoury MJ, Lammer EJ, Waller KO, Cordero JF, Erickson JD. 1990. Sensitivity, specificity, and positive predictive value of multiple malformations in isoretinoin embryopathy surveillance. Teratology 42:513-519. (Pubitemid 20383740)
23. McDonald MT, Gorksi JI. 1993. Syndrome of the month: Nager acrofacial dysostosis. J Med Genet 30:779-782.
24. McKay DB, Josephson MA. 2006. Pregnancy in recipients of solid organs - Effects on mother and child. N Engl J Med 354:1281-1293.
25. Meier-Kriesche HU, Li S, Gruessner RWG, Fung JJ, Bustami RT, Barr ML, Leichman AB. 2006. Immunosuppression: Evolution in practice and trends 1994-2004. Am J Transplant 6:1111-1113.
26. Moller HU. 2005. Milestones and normative data. In: Taylor D, Hoyt CS, editors. Pediatric Ophthalmology and Strabismus. 3rd edition. Philadelphia: Elsevier Saunders, Blackwell Science. pp 32-42.
27. Opitz JM, Mollica F, Sorge G, Milana G, Cimino G, Caltabiano M. 1993. Acrofacial dysostoses: Review and report of a previously undescribed condition: The autosomal or X-linked dominant Catania form of acrofacial dysostosis. Am J Med Genet 47:660-678. (Pubitemid 23291981)
28. Perez-Aytes A, Ledo A, Boso V, Saenz P, Roma E, Poveda JL, Vento M. 2007. In utero exposure to mycophenolate mofetil: A characteristic phenotype? Am J Med Genet Part A 146A:1-7.
29. Pérgola PE, Kancharla A, Riley DJ. 2001. Kidney transplantation during the first trimester of pregnancy: Immunosuppression with mycophenolate mofetil, tacrolimus and prednisone. Transplantation 71: 994-997. (Pubitemid 32417365)
30. Phadungkiawattana P, Sirivatanapa P, Tongsong T. 2007. Outcomes of pregnancies complicated by systemic lupus erythematosus (SLE). J Med Assoc Thai 90:1981-1985. (Pubitemid 350057088)
31. Roche Laboratories. 2007. Mycophenolate mofetil package insert. Nutley NJ. Revised 10/2007. http://www.rocheusa.com/products/cellcept/pi.pdf. Accessed 4/14/08.
32. Sanlaville D, Verloes A. 2007. CHARGE syndrome: An update. Eur J Hum Genet 15:389-399. (Pubitemid 46487692)
33. Schoner K, Steinhard J, Figiel J, Rehder H. 2008. Severe facial clefts in acrofacial dystosis: A consequence of prenatal exposure to mycophenolate mofetil? Obstet Gynecol 111:483-486.
34. Sebaaly ZE, Charpentier B, Snanoudj R. 2007. Fetal malformations associated with mycophenolate mofetil for lupus nephritis. Nephrol Dial Transplant 22:2722-2732. (Pubitemid 47365542)
35. Shepard TH. 1994. "Proof" of human teratogenicity. Teratology 50:97-98.
36. Sifontis NM, Coscia LA, Constantinescu S, Lavelanet A, Moritz MJ, Armenti VT. 2006. Pregnancy outcomes in solid organ transplant with exposure to mycophenolate mofetil or sirolimus. Transplantation 82:1698-1702. (Pubitemid 46035654)
37. Tendron A, Gouyon JB, Decramer S. 2002. In utero exposure to immunosuppressive drugs: Experimental and clinical studies. Pediatr Nephrol 17:121-130.
38. Tjeertes IFA, Bastiaans DET, van Ganzewinkel CJLM, Zegers SHJ. 2007. Neonatal anemia and hydrops fetalis after maternal mycophenolate mofetil use. J Perinatol 27:62-64. (Pubitemid 44971056)
39. Velinov M, Zellers N. 2008. The fetal mycophenolate mofetil syndrome. Clin Dysmorphol 17:77-78.
40. Vento AR, LaBrie RA, Mulliken JB. 1991. The O.M.E.N.S. classification of hemifacial microsomia. Cleft Palate Craniofac J 28:68-76.
41. Vento M, Perez-Aytes A, Ledo A, Boso V, Carey JC. 2008. Mycophenolate mofetil during pregnancy: Some words of caution. Pediatrics 122:184-185.
42. Verloes A. 1994. Hypertelorism-microtia-clefting (HMC) syndrome. Genet Couns 5:283-287.
43. Vila JHA, da Silva JP, Guilhen CJ, Baumgratz JF, da Fonseca L. 2008. Even low dose of mycophenolate mofetil in a mother recipient of heart transplant can seriously damage the fetus. Transplantation 86:369-370.