title: Sudden hearing loss associated with tacrolimus after pediatric renal transplant.
abstract: OBJECTIVE
  Hearing impairment is a frequent problem that can easily influence the quality of life for the individual. It may affect one's social and academic life. Knowledge regarding hearing impairment after renal transplant is sparse. It has been suggested that renal transplant improves hearing function. Potential ototoxic side effects may be related to immunosuppression with calcineurin inhibitors. In pediatric renal transplanted patients, we do not have enough information about this subject. We report 2 cases that developed sudden hearing loss after a renal transplant that was associated with high serum levels of tacrolimus.
  
  
  METHODS
  Two renal transplanted children (a 15-year-old boy and a 17-year-old girl), in the fourth year of their follow-up after transplant, developed symptomatic bilateral sudden hearing loss. There was a marked hearing impairment for the higher frequencies between 4000 and 8000 Hz in pure-tone audiometry evaluation. Also, a decrease of speech understanding was found, but the patients were not conscious of this problem. Hearing loss in these patients was not associated with any known risk factors such as chronic renal disease, ototoxic drugs, or acoustic trauma. Sudden hearing loss occurred under high serum levels of tacrolimus, and after dosage correction of tacrolimus pure-tone audiometry ruled out hearing loss progression for each patient.
  
  
  CONCLUSIONS
  Awareness of this potential complication of tacrolimus may be helpful for early recognition and treatment.
authors.affiliation: Department of Pediatric Nephrology, Baskent University, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Gulleroglu
authors.forename: Esra
authors.initials: E
authors.lastname: Baskin
authors.forename: Umut
authors.initials: U
authors.lastname: Bayrakci
authors.forename: Erdinc
authors.initials: E
authors.lastname: Aydin
authors.forename: Levent
authors.initials: L
authors.lastname: Ozluoglu
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D004305:Dose-Response Relationship, Drug; D005260:Female; D006310:Hearing Aids; D003639:Hearing Loss, Sudden / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D011788:Quality of Life; D051437:Renal Insufficiency / Q000601:surgery; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus