Mycophenolate Mofetil-induced Multiple Ileal Ulcerations in a Renal Transplant Recipient: Diagnostic Challenges and Management

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We herein report a kidney transplant recipient with recurrent bleeding due to multiple ileal ulcerations associated with mycophenolate mofetil (MMF). Symptoms persisted despite surgical resection and embolization. Double-balloon enteroscopy revealed multiple ulcerations, and a biopsy helped exclude other causes. The discontinuation of MMF led to rapid symptom resolution and healing of the ulceration. Intestinal complications after renal transplantation vary, and MMF-induced enteritis, although rare, should be considered. This case highlights the diagnostic value of enteroscopy in identifying drug-induced small intestinal injuries and underscores the importance of including MMF in the differential diagnosis of post-transplant gastrointestinal bleeding.