title: An unusual case of calcineurine inhibitor pain syndrome.
abstract: Cyclosporine induced pain syndrome (CIPS) is a newly diagnosed complication of calcineurine inhibitors, mainly observed in solid organ and hematopoetic transplantations. The present case is a male child with steroid resistant nephrotic syndrome on low therapeutic level cyclosporine treatment. He presented with intractable and debilitating leg pain, with no reported history of previous injury or trauma. The pain was reluctant to antimicrobial and sedative treatment. MRI revealed bone marrow and soft tissue edema in the mid shaft of patient's right leg. Inspite of unusual manifestations, CIPS was suggested and cyclosporine discontinued. However, the pain did not improve and was resistant to calcium blocker. Subsequently, core decompression was performed as an unusual treatment of CIPS, revealing normal bone morphology. The pain improved rapidly and the patient was discharged a few days later.
authors.affiliation: Department of Pediatric Nephrology, aliasghar childrens hospital, Iran University of Medical Sciences, Tehran, 1919816766, Iran, anickavar@yahoo.com.
authors.forename: Azar
authors.initials: A
authors.lastname: Nickavar
authors.forename: Mitra
authors.initials: M
authors.lastname: Mehrazma
authors.forename: Farideh
authors.initials: F
authors.lastname: Hallaji
mesh_terms: D065095:Calcineurin Inhibitors / Q000009:adverse effects*; D002648:Child; D016572:Cyclosporine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010146:Pain / Q000139:chemically induced*; D013577:Syndrome
chemical_list: D065095:Calcineurin Inhibitors; D016572:Cyclosporine