Microangiopathic hemolytic anemia complicating FK506 (tacrolimus) therapy.
We describe 3 episodes of microangiopathic hemolytic anemia (MAHA) in 2 solid organ recipients under FK506 (tacrolimus) therapy. In both cases, discontinuation of FK506 and treatment with plasma exchange, fresh frozen plasma replacement, corticosteroids, aspirin, and dipyridamole led to resolution of MAHA. In one patient, reintroduction of FK506 led to rapid recurrence of MAHA. FK506-associated MAHA is probably rare but physicians must be aware of this severe complication. In our experience and according to the literature, FK506 does not seem to cross-react with cyclosporin A (CyA), an immuno-suppressive drug already known to induce MAHA.
Mach-Pascual
S
S
Division of Hematology, University Hospital, Geneva, Switzerland.
Samii
K
K
Beris
P
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D004176:Dipyridamole / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010949:Plasma; D010951:Plasma Exchange; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D004176:Dipyridamole; D001241:Aspirin; D016559:Tacrolimus