Cyclosporine-associated lymphoproliferation, despite controlled cyclosporine blood concentrations, in a renal allograft recipient.
In a patient receiving sulfinpyrazone (Anturan, Geigy) an unusually high dose of cyclosporine (Cys) was required to maintain serum values in the range of 50-200 ng/ml. After eight months of 1300-1500 mg/day, the patient complained of increasing malaise and symptoms of cyclosporine side-effects. This clinical state was accompanied by splenomegaly and two monoclonal peaks in the gamma region on serum electrophoresis. Concomitantly, rising cytomegalovirus IgM titres, following by rising IgG titres, indicated a primary cytomegalovirus infection. This ominous biclonal proliferation markedly diminished during the subsequent six months, during which time the cyclosporine dose was minimised. He returned to good health, splenomegaly and monoclonal gamma globulin virtually disappearing. He remains well at 16 months post-transplantation.
Dossetor
J B
JB
Kovithavongs
T
T
Salkie
M
M
Preiksaitis
J
J
D003524:Cyclosporins / Q000009:adverse effects* / Q000097:blood; D003586:Cytomegalovirus Infections / Q000150:complications; D006801:Humans; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013442:Sulfinpyrazone / Q000009:adverse effects
D003524:Cyclosporins; D013442:Sulfinpyrazone