Cyclosporine-Associated Thrombotic Microangiopathy during Daclizumab Induction: A Suggested Therapeutic Approach

Trimarchi, Hernán; Freixas, Emilio; Rabinovich, Oscar; Schropp, Juan; Pereyra, Horacio; Bullorsky, Eduardo

doi:10.1159/000045943

Cited by 9 publications

(3 citation statements)

References 9 publications

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“…Therefore, these changes of therapy should be made with great caution. Plasma exchange in addition to CNI withdrawal resulted in a graft salvage rate of 80% in two series [30,56] and in other anecdotal cases [18,65]. The addition of i.v.…”

Section: De Novo Post‐transplant Tmamentioning

confidence: 99%

Thrombotic microangiopathy after kidney transplantation

Ponticelli¹,

Banfi²

2006

Transplant Int

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Summary Two forms of post‐transplant thrombotic microangiopathy (TMA) may be recognized: recurrent TMA and de novo TMA. Recurrent TMA may occur in patients who developed a nondiarrhoeal form of haemolytic uraemic syndrome (HUS) being particularly frequent in patients with autosomal recessive or dominant HUS. The recurrence is almost the rule in patients with mutation in complement factor H gene. Most patients eventually lose the graft. Treatment with plasma infusions or plasmapheresis is often disappointing, but few cases may be rescued. Intravenous immunoglobulins and rituximab have also been successful in anedoctic cases. De novo TMA is rarer. A number of factors including viral infection may be responsible of de novo TMA, but in most cases TMA is triggered by calcineurin inhibitors or mTOR inhibitors. The clinical presentation of de novo TMA may be variable with some patients showing clinical and laboratory features of HUS while others showing only a progressive renal failure. The prognosis is less severe than with recurrent TMA. Complete withdrawal of the offending drug may lead to improvement in many cases. The addition of plasma exchange may result in graft salvage in about 80% of cases.

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Section: De Novo Post‐transplant Tmamentioning

confidence: 99%

Thrombotic microangiopathy after kidney transplantation

Ponticelli¹,

Banfi²

2006

Transplant Int

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“…The definitive diagnosis is usually established with the renal biopsy. Tacrolimus has been used successfully as rescue therapy for Csa‐associated TMA and vice versa with tacrolimus‐associated TMA (52,63, 67–69). In one case series of Csa‐associated TMA, the substitution with tacrolimus resulted in a 1‐year graft salvage of 80% ( N = 16) (52).…”

Section: Immunotherapymentioning

confidence: 99%

“…In one case series of Csa‐associated TMA, the substitution with tacrolimus resulted in a 1‐year graft salvage of 80% ( N = 16) (52). As a supplement to either dose reduction or drug discontinuation plasma exchange has been used (69). However, there are no known prospective studies to establish its efficacy.…”

Section: Immunotherapymentioning

confidence: 99%

Drug‐induced Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome: A Concise Review

et al. 2004

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An extensive variety of drugs have been associated with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP/HUS). Although a direct causal effect has usually not been proven, the cumulative evidence linking several drugs with TTP/HUS is strong. This paper reviews several categories of drugs including antineoplastics, immunotherapeutics and anti-platelet agents that have been reported to induce TTP/HUS. The pathogenesis of drug-induced TTP/HUS and the effectiveness of treatment regimens are also reviewed. A consensus on diagnostic criteria to accurately and consistently diagnose drug-induced TTP is needed.

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Current Awareness

2001

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Cyclosporine-Associated Thrombotic Microangiopathy during Daclizumab Induction: A Suggested Therapeutic Approach

Cited by 9 publications

References 9 publications

Thrombotic microangiopathy after kidney transplantation

Thrombotic microangiopathy after kidney transplantation

Drug‐induced Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome: A Concise Review

Current Awareness

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