title: Marked erythrocyte microcytosis under primary immunosuppression with sirolimus.
abstract: The preliminary observation of marked erythrocyte microcytosis in patients treated with sirolimus (SRL) and mycophenolate mofetil (MMF) has been evaluated as part of a prospective study comparing SRL and cyclosporin A (CsA) as a primary immunosuppressant. Normal risk de novo kidney recipients were randomized either to SRL or to CsA. Additional immunosuppressants consisted of MMF and prednisone. In patients with erythrocyte microcytosis, iron deficiency was excluded by measuring serum ferritin and transferrin saturation rate. Fifty-nine patients (30 in SRL and 29 in CsA) were included. Mean corpuscular volume (MCV) (fl) on day 7 was 91.7 +/- 4.8 in SRL group versus 91.4 +/- 4.2 in CsA group (P = 0.77), whereas mean MCV on day 183 post-transplant was 78.5 +/- 3.8 in SRL group versus 88.4 +/- 3.4 in CsA group (P < 0.0001). Hemoglobin concentration (g/dl) was not significantly different. Only two patients in SRL group presented decreased transferrin saturation rate. Marked erythrocyte microcytosis without persistent anemia was observed in patients treated with SRL and MMF.
authors.affiliation: Division of Transplantation Immunology and Nephrology, University Hospital, Basel, Switzerland. min-jeong.kim@ksl.ch
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Kim
authors.forename: Michael
authors.initials: M
authors.lastname: Mayr
authors.forename: Martina
authors.initials: M
authors.lastname: Pechula
authors.forename: Jürg
authors.initials: J
authors.lastname: Steiger
authors.forename: Michael
authors.initials: M
authors.lastname: Dickenmann
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000627:therapeutic use; D004913:Erythrocytes, Abnormal / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000009:adverse effects*
chemical_list: D006454:Hemoglobins; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus