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Tacrolimus‐induced hemolytic uremic syndrome and end‐stage renal failure after liver transplantation
Author(s) -
Rerolle JeanPhilippe,
Akposso Kodzo,
Lerolle Nicolas,
Mougenot Béatrice,
Ponnelle Tibor,
Rondeau Eric,
Sraer JeanDaniel
Publication year - 2000
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2000.140314.x
Subject(s) - medicine , microangiopathic hemolytic anemia , transplantation , gastroenterology , tacrolimus , thrombotic microangiopathy , liver transplantation , kidney disease , hemodialysis , thrombotic thrombocytopenic purpura , urology , surgery , disease , platelet
Background. Hemolytic uremic syndrome (HUS) is a rare complication in solid organ transplantation. It can be associated with severe hypertension. Several risk factors have been identified including immunosuppressive drugs such as cyclosporin A and, more recently, tacrolimus.
Methods. Here we report a case of tacrolimus‐induced HUS in a 61‐yr‐old woman after liver transplantation. Hypertension, microangiopathic anemia and end‐stage renal failure occurred 2 yr after liver transplantation.
Results. At admission, she had malignant hypertension with a severe hypertensive retinopathy, renal failure (creatininemia: 800 μmol/L) and microangiopathic anemia (Hb: 7.3 g/dL, a low platelet count and elevated lactate dehydrogenase). At renal biopsy, histologic findings were ischemic and sclerotic glomeruli with hyaline thrombi, severe mesangiolysis and interstitial fibrosis.
Conclusion. Despite steroid treatment, antihypertensive agents and fresh frozen plasma therapy, end‐stage renal failure was observed and chronic hemodialysis treatment was required.