A 55-year-old man comes to the physician for a follow-up examination. One month ago, he underwent a right-sided kidney transplantation due to severe polycystic kidney disease. Following the procedure, he was started on transplant rejection prophylaxis. He has had 5-6 bowel movements per day of loose stool and occasional vomiting. He appears pale. Temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 155/90 mm Hg. Physical examination shows no abnormalities. he is given a medication that inhibits the conversion of inosine monophosphate to guanosine monophosphate primarily in lymphocytes, causing reduced proliferation of activated lymphocytes. Which of the following is the most likely underlying cause of this patient's laboratory findings?

Question

A 55-year-old man comes to the physician for a follow-up examination. One month ago, he underwent a right-sided kidney transplantation due to severe polycystic kidney disease. Following the procedure, he was started on transplant rejection prophylaxis. He has had 5-6 bowel movements per day of loose stool and occasional vomiting. He appears pale. Temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 155/90 mm Hg. Physical examination shows no abnormalities. he is given a medication that inhibits the conversion of inosine monophosphate to guanosine monophosphate primarily in lymphocytes, causing reduced proliferation of activated lymphocytes. Which of the following is the most likely underlying cause of this patient's laboratory findings?

Quizplus · Accepted Answer

Eductional Objective: Mycophenolate is an immunosuppression drug that inhibits inosine 5'-monophosphate dehydrogenase in the de novo purine synthesis pathway.  It provides relatively specific suppression of lymphocyte proliferation, largely because activated lymphocytes lack an established purine salvage pathway that is present in other hematopoietic cell lines.

A 55-Year-Old Man Comes to the Physician for a Follow-Up