Tacrolimus-induced neutropenia in renal transplant recipients.
Tacrolimus has become an important cornerstone in the prevention of rejection after kidney transplantation. However, its use has been complicated by several side effects, including chronic allograft nephropathy, diabetes mellitus, arterial hypertension, and neurotoxicity. Tacrolimus-induced neutropenia is a less recognized, but potentially harmful complication. Three patients with severe neutropenia developing within 3 months after kidney transplantation are described. After having excluded other well known causes, tacrolimus was considered the most probable culprit. Definitive proof of this hypothesis was obtained by discontinuation of tacrolimus and switching to cyclosporine, which led to recovery of white blood cell count in all three patients.
Department of Nephrology, University Hospitals Leuven, Leuven, Belgium.
Anja
A
De Rycke
Daan
D
Dierickx
Dirk R
DR
Kuypers
D016572:Cyclosporine / Q000627:therapeutic use; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine; D016559:Tacrolimus