Tacrolimus pain syndrome in renal transplant patients: report of two cases
Tacrolimus pain syndrome in renal transplant patients: report of two cases
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DOI：
10.1016/s1297-319x(03)00095-2
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发表时间：
2004-03-01
期刊：
影响因子：
4.2
通讯作者：
Jaeger, P
中科院分区：
文献类型：
--
作者：
Franco, M;Blaimont, A;Jaeger, P
我们报告了两例肾移植患者，在接受他克莫司治疗时，分别在移植后1个月和3个月出现严重的双侧膝关节疼痛。他克莫司，像环孢霉素A，是一种免疫抑制剂，灭活钙调磷酸酶。1989年，在接受环孢素A治疗的器官移植受者中报告了骨痛综合征。我们的病例提示他克莫司可能引起同样的综合征。锝99m骨扫描显示受累区域摄取增加，磁共振成像改变与骨髓水肿一致。他克莫司剂量不需要减少，除非谷浓度过高。症状在几个月内完全消失。应进行影像学检查以排除缺血性坏死。这种综合征的病理生理进行了讨论。由于他克莫司是最近引进的，类似的病例应该被发表。(C)2003年，Elsevier SAS。All rights reserved.
We report two renal transplant patients who experienced onset of severe bilateral knee pain 1 and 3 months after transplantation, respectively, while on tacrolimus therapy. Tacrolimus, like cyclosporine A, is an immunosuppressive agent that inactivates the enzyme calcineurin phosphatase. A bone pain syndrome was reported in 1989 in organ transplant recipients treated with cyclosporine A. Our cases suggest that tacrolimus may induce the same syndrome. Technetium 99m bone scanning shows increased uptake in the affected areas, and magnetic resonance imaging changes are consistent with bone marrow edema. The tacrolimus dosage need not be reduced unless trough levels are too high. The symptoms resolve completely within a few months. Imaging studies should be done to rule out avascular necrosis. The pathophysiology of this syndrome is discussed. Since tacrolimus was introduced recently, similar cases should be published. (C) 2003 Elsevier SAS. All rights reserved.