A peculiar vacuolization in the kidney transplant of a child treated with tacrolimus.
Tacrolimus (TAC) is a useful immunosuppressive agent in the prevention of rejection. However, the blood level between its therapeutic and toxic levels is narrow such that its nephrotoxicity is a problem. Moreover, its bioavailability and pharmacokinetics are highly variable. We experienced a case of acute nephrotoxicity, in which the blood level rose about 10 times above the expected level. We found a peculiar vacuolization in the transplant biopsy specimen. This change showed a marked vacuolization of the tubular cells, suggestive of acute nephrotoxicity by TAC.
Watanabe
S
S
Department of Pediatric Nephrology, Tokyo Women's Medical University, Japan. swata@kc.twmu.ac.jp
Yamaguchi
Y
Y
Hattori
M
M
Chikamoto
H
H
Matsumoto
N
N
Suzuki
T
T
Oonishi
M
M
Horita
S
S
Tokumoto
T
T
Tanabe
K
K
Shiraga
H
H
Toma
H
H
Ito
K
K
D000293:Adolescent; D001706:Biopsy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D016030:Kidney Transplantation / Q000473:pathology*; D007684:Kidney Tubules / Q000187:drug effects* / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D016559:Tacrolimus / Q000009:adverse effects* / Q000493:pharmacokinetics; D014617:Vacuoles / Q000473:pathology*
D007166:Immunosuppressive Agents; D016559:Tacrolimus