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Treatment with sirolimus ameliorates tacrolimus‐induced autoimmune cytopenias after solid organ transplant
Author(s) -
Teachey David T.,
Jubelirer Tracey,
Baluarte H. Jorge,
Wade Amanda,
Manno Catherine S.
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22183
Subject(s) - medicine , sirolimus , tacrolimus , immunosuppression , organ transplantation , immune dysregulation , transplantation , autoimmune disease , immunology , autoimmunity , immune system , antibody
The development of autoimmune blood cell cytopenias is a potentially life‐threatening complication of solid organ transplantation, resulting from T‐cell dysregulation from immunosuppressive medications. Conventional treatment with corticosteroids and IVIgG is often unsuccessful as these therapies are unlikely to overcome the T‐cell dysregulation. We describe two patients who developed severe autoimmune cytopenias after solid organ transplantation. They had limited response to conventional medications, but had complete resolution of autoimmunity upon transition of immunosuppression from tacrolimus to sirolimus. Altering the immunosuppressive regimen to modify T‐cell dysregulation may be beneficial for patients who develop post‐transplant autoimmune disease and allow continued preservation of allograft. Pediatr Blood Cancer 2009;53:1114–1116. © 2009 Wiley‐Liss, Inc.