title: A peculiar vacuolization in the kidney transplant of a child treated with tacrolimus.
abstract: 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.
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, Japan. swata@kc.twmu.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: M
authors.initials: M
authors.lastname: Hattori
authors.forename: H
authors.initials: H
authors.lastname: Chikamoto
authors.forename: N
authors.initials: N
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Oonishi
authors.forename: S
authors.initials: S
authors.lastname: Horita
authors.forename: T
authors.initials: T
authors.lastname: Tokumoto
authors.forename: K
authors.initials: K
authors.lastname: Tanabe
authors.forename: H
authors.initials: H
authors.lastname: Shiraga
authors.forename: H
authors.initials: H
authors.lastname: Toma
authors.forename: K
authors.initials: K
authors.lastname: Ito
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus