title: Raised tacrolimus level and acute renal injury associated with acute gastroenteritis in a child receiving local rectal tacrolimus.
abstract: Local rectal application of tacrolimus in distal colitis, pouchitis and perianal Crohn's disease has previously been reported to be both effective and safe. We report a patient treated with per rectum local application of tacrolimus, who developed toxic levels of tacrolimus and acute renal injury during an episode of acute gastroenteritis. This case illustrates that local application of tacrolimus, although usually safe, may be associated with significantly raised tacrolimus levels and acute renal injury during acute gastroenteritis. It is important for physicians to be aware of this association when prescribing local rectal tacrolimus.
authors.affiliation: Department of Gastroenterology, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia, lee.gastro@gmail.com.
authors.forename: Cheng Hiang
authors.initials: CH
authors.lastname: Lee
authors.forename: Natalie
authors.initials: N
authors.lastname: Tasker
authors.forename: Erik
authors.initials: E
authors.lastname: La Hei
authors.forename: Shoma
authors.initials: S
authors.lastname: Dutt
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced*; D000285:Administration, Rectal; D002648:Child; D005759:Gastroenteritis / Q000097:blood* / Q000150:complications*; D006801:Humans; D008297:Male; D019449:Pouchitis / Q000188:drug therapy; D011349:Proctitis / Q000188:drug therapy; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood*
chemical_list: D016559:Tacrolimus