Calcineurin-inhibitor induced pain syndrome (CIPS): a severe disabling complication after organ transplantation
Calcineurin-inhibitor induced pain syndrome (CIPS): a severe disabling complication after organ transplantation
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DOI：
10.1007/s001470000285
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发表时间：
2001-01-01
影响因子：
3.1
通讯作者：
Schollmeyer, PJ
中科院分区：
文献类型：
--
作者：
Grotz, WH;Breitenfeldt, MK;Schollmeyer, PJ
移植后骨痛是一种常见的并发症，可由多种疾病引起。治疗策略取决于疼痛的正确诊断。对移植后登记的九名足部剧烈疼痛的患者进行了调查。骨扫描显示脚骨的示踪剂摄取增加。磁共振成像显示疼痛的骨头中有骨髓水肿。疼痛不能用其他引起足部疼痛的疾病来解释，如反射性交感神经营养不良、多发性神经病、莫顿神经痛、痛风、骨质疏松症、缺血性坏死、间歇性跛行、足部矫形畸形、应力性骨折和甲状旁腺功能亢进。环孢素或他克莫司谷水平的降低以及钙通道阻滞剂的施用导致疼痛缓解。钙调神经磷酸酶抑制剂诱发的疼痛综合征 (CIPS) 是环孢素或他克莫司的一种罕见但严重的副作用，可通过其典型表现、磁共振成像和骨扫描进行准确诊断。该综合征的错误诊断将导致 CIPS 患者的生活质量显着下降。
Bone pain after transplantation is a frequent complication that can be caused by several diseases. Treatment strategies depend on the correct diagnosis of the pain. Nine patients with severe pain in their feet, which was registered after transplantation, were investigated. Bone scans showed an increased tracer uptake of the foot bones. Magnetic resonance imaging demonstrated bone marrow oedema in the painful bones. Pain was not explained by other diseases causing foot pain, like reflex sympathetic dystrophy, polyneuropathy, Morton's neuralgia, gout, osteoporosis, avascular necrosis, intermittent claudication, orthopaedic foot deformities, stress fractures, and hyperparathyroidism. The reduction of cyclosporine- or tacrolimus trough levels and the administration of calcium channel blockers led to relief of pain. The Calcineurin-inhibitor Induced Pain Syndrome (CIPS) is a rare but severe side effect of cyclosporine or tacrolimus and is accurately diagnosed by its typical presentation, magnetic resonance imaging and bone scans. Incorrect diagnosis of the syndrome will lead to a significant reduction of life quality in patients suffering from CIPS.