skip to main content

MMF Leucopenia LN — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGlomerulonephritisMMF Leucopenia LNESENeph

A 42-year-old woman with SLE and lupus nephritis Class IV on Mycophenolate, Prednisolone, and Hydroxychloroquine develops leucopenia (WCC 2.0 x 10^9/L, neutrophils 0.8 x 10^9/L). What is the most likely drug cause and what action should be taken?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Mycophenolate mofetil – reduce dose or hold; check for other causes of leucopenia (SLE flare, infection)

Leucopenia and neutropenia are dose-dependent adverse effects of Mycophenolate mofetil (via its antiproliferative mechanism on lymphocytes and granulocytes). KDIGO 2024 LN guideline recommends monitoring FBC regularly during MMF therapy. The dose should be reduced or held if neutrophils fall below 1.5 x 10^9/L. Importantly, leucopenia in SLE can also be due to disease activity (autoimmune cytopenias), so differentiating drug-induced from disease-related leucopenia requires clinical judgement (anti-dsDNA, complement, disease activity scores).

Reference: KDIGO 2024 – Lupus Nephritis; BNF – Mycophenolate ADRs