Conversion from tacrolimus to cyclosporine for a non-dose-dependent tacrolimus-induced toxicity, a pediatric kidney transplant recipient case report

Transplantation Proceedings
L GhioA Edefonti

Abstract

Tacrolimus-induced toxicity is considered a dose-related side effect largely due to a direct action of this potent calcineurin inhibitor on its targets including the kidney and the pancreas. This paper describes a case of tacrolimus systemic toxicity that appeared in a pediatric kidney transplant recipient who received a low drug dose. The kidney biopsy was a crucial aid toward the correct diagnosis, which reversed upon conversion to cyclosporine-based immunosuppression. A review of the literature suggests a chance of systemic toxicity even when the patient is maintained on therapeutic levels of tacrolimus. Because idiosyncratic reactions to the drug have not yet been postulated, we conclude that this suspicion may be addressed by a safe conversion to cyclosporine in pediatric patients.

References

Aug 15, 1992·Proceedings of the National Academy of Sciences of the United States of America·A AperiaP Greengard
Aug 1, 1995·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·D Ellis
Dec 1, 1995·Clinical Pharmacokinetics·R VenkataramananT Starzl
Nov 14, 1997·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·P Lang, C Baron
Feb 13, 1999·Kidney International·L C RacusenY Yamaguchi
Feb 12, 1999·Transplantation·R ShapiroT E Starzl
Jan 17, 2002·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Louise C GreenspanRobert S Mathias

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Citations

Apr 24, 2010·Transplant Infectious Disease : an Official Journal of the Transplantation Society·H-Y Sun, N Singh

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