Tacrolimus
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Thrombotic microangiopathy in an infant: case report A 1-year-old girl developed thrombotic microangiopathy while receiving tacrolimus. The girl had started receiving tacrolimus [dosage and route not stated] with prednisone for immunosuppression following a liver transplant at the age of 5 months. She developed severe haemolytic anaemia with a sudden decrease in haemoglobin, 8 months after receiving the transplant. At admission, her liver function test were slightly elevated. Autoimmune and alloimmune causes for the haemolysis were ruled out. Her liver function continued to deteriorate; a liver biopsy showed secondary haemochromatosis but did not indicate infection or rejection. Drug toxicity was suspected; tacrolimus was discontinued and the girl received sirolimus. Six weeks later, her blood count had significantly improved. Her prednisone dosage was slowly reduced, and discontinued after 2 years. At follow-up 6 years later, there was no relapse of thrombotic microangiopathy. Author comment: "We present the case of [thrombotic microangiopathy] in a child receiving tacrolimus after [livingrelated liver transplantation], successfully converted to sirolimus with no [thrombotic microangiopathy] relapse in 6 years follow-up." Czubkowski P, et al. Successful sirolimus rescue in tacrolimus-induced thrombotic microangiopathy after living-related liver transplantation. Pediatric Transplantation 16: E261-E264, No. 6, Sep 2012. Available from: URL: http://dx.doi.org/10.1111/ 803078147 j.1399-3046.2011.01601.x - Poland
0114-9954/10/1422-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 6 Oct 2012 No. 1422
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