title: Pain syndrome induced by calcineurin inhibitor and resolved by conversion to sirolimus in a child after kidney transplantation: a case report.
abstract: Pain induced by calcineurin inhibitors is a rare complication of unknown pathogenesis. We have reported herein a 7-year-old child who presented with abdominal pain, vomiting, and weight loss showing no significant findings after an extensive laboratory and imaging workup. After conversion from tacrolimus to sirolimus, there was complete resolution of the gastrointestinal symptoms and pain; the patient displays excellent renal function. Calcineurin inhibitor-induced pain syndrome is diagnosis of exclusion but must be considered because the withdrawal of this immunosuppressive agent is associated with improvement in symptoms and quality of life.
authors.affiliation: Discipline of Pediatric Nephrology/Department of Pediatrics-State University of Campinas, São Paulo, Brazil. lilianecprates@terra.com.br
authors.forename: L C
authors.initials: LC
authors.lastname: Prates
authors.forename: S Z P
authors.initials: SZ
authors.lastname: Rigatto
authors.forename: A C B
authors.initials: AC
authors.lastname: Lutaif
authors.forename: L C
authors.initials: LC
authors.lastname: Oliveira
authors.forename: L M
authors.initials: LM
authors.lastname: Pereira
authors.forename: L C
authors.initials: LC
authors.lastname: Passerotti
authors.forename: V M S
authors.initials: VM
authors.lastname: Belangero
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D065095:Calcineurin Inhibitors; D002648:Child; D057915:Drug Substitution; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology*; D020123:Sirolimus / Q000627:therapeutic use*; D016559:Tacrolimus / Q000009:adverse effects*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy; D015431:Weight Loss / Q000187:drug effects
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus