Mycophenolate Mofetil-Related Celiac-Like Enteropathy With Devastating Superior Mesenteric Artery Thrombosis and Gobbi Syndrome in a Renal Transplant Recipient

Mycophenolate mofetil, an immunosuppressant widely used in transplantation to prevent acute rejection, is generally considered to have a relatively benign adverse effect profile, which manifests in a spectrum of gastrointestinal disorders. We presented a case of de novo celiac-like enteropathy, epilepsy, and cerebral occipital calcifications-characteristics known in Gobbi syndrome-in a patient who had been on a prolonged regimen of mycophenolate mofetil after a renal transplant. These devastating complications highlight the need for vigilance in monitoring patients on mycophenolate mofetil for both gastrointestinal and associated neurological symptoms. Further research is essentially needed to address the mechanisms by which mycophenolate mofetil causes celiac-like disease in order to develop evidence-based guidelines for management.