title: Resolution of diffuse skin and systemic Kaposi's sarcoma in a renal transplant recipient after introduction of everolimus: a case report.
abstract: We present a case report of a patient with diffuse skin and systemic Kaposi's sarcoma (KS), 1 year after renal transplantation. A concomitant Pyrenochaeta romeroi granuloma of the right hallux was diagnosed and illustrated an important immunodysfunction in our patient. Four months after reduction in immunosuppression and switch to everolimus, a total regression of the KS was observed. Reduction in the immunosuppression and treatment with terbinafine cleared the P. romeroi infection, while lowering immunosuppression and changing the type of immunosuppressive therapy were important steps in the successful management of the KS. In recent years, evidence of the antitumor effects of everolimus is increasing: total regression of KS in combination with renal function preservation in renal graft recipients is possible with mammalian target of rapamycin (mTOR) inhibitor-based regimens. In addition, with increasing numbers of human immunodeficiency virus-positive transplant recipients, mTOR inhibitors may play a more crucial role in the management of KS.
authors: Department of Nephrology, UZ Leuven, Leuven, Belgium.
authors: D
authors: D
authors: Detroyer
authors: K
authors: K
authors: Deraedt
authors: P
authors: P
authors: Schöffski
authors: E
authors: E
authors: Hauben
authors: K
authors: K
authors: Lagrou
authors: M
authors: M
authors: Naesens
authors: M L
authors: ML
authors: Delforge
authors: D
authors: D
authors: Kuypers
mesh_terms: D000328:Adult; D003881:Dermatomycoses / Q000209:etiology* / Q000276:immunology; D057915:Drug Substitution; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008113:Liver Neoplasms / Q000209:etiology* / Q000276:immunology; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D012514:Sarcoma, Kaposi / Q000209:etiology* / Q000276:immunology; D012878:Skin Neoplasms / Q000209:etiology* / Q000276:immunology; D016559:Tacrolimus / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D009173:Mycophenolic Acid; D016559:Tacrolimus
keywords: Kaposi's sarcoma; Kaposi's sarcoma herpesvirus; Pyrenochaeta romeroi; immunosuppression; mTOR inhibitor; renal transplantation