title: Polyarteritis nodosa type vasculitis in a patient with familial Mediterranean fever treated with cyclosporin A.
abstract: Patients with amyloidosis secondary to familial Mediterranean fever (FMF) are known to tolerate cyclosporin A poorly. We report a case of severe cyclosporin toxicity in a patient with FMF amyloidosis who underwent kidney transplantation. The clinical syndrome consisted of severe gastrointestinal, neuromuscular, and psychiatric disturbances. Histological examination of the transplanted kidney revealed vasculitis of the polyarteritis nodosa type. We hypothesize that FMF patients are more vulnerable to the acute vascular toxicity of cyclosporin due to defective inhibition of complement activation, leading to a widespread vasculitis of the polyarteritis nodosa type.
authors.affiliation: Department of Nephrology, University Hospital, U.Z. Gasthuisberg, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Henckes
authors.forename: T
authors.initials: T
authors.lastname: Roskams
authors.forename: S
authors.initials: S
authors.lastname: Vanneste
authors.forename: B
authors.initials: B
authors.lastname: Van Damme
authors.forename: Y
authors.initials: Y
authors.lastname: Vanrenterghem
mesh_terms: D000328:Adult; D000686:Amyloidosis / Q000209:etiology / Q000601:surgery; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D010505:Familial Mediterranean Fever / Q000150:complications*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D010488:Polyarteritis Nodosa / Q000139:chemically induced* / Q000473:pathology; D012086:Reoperation
chemical_list: D016572:Cyclosporine