Severe bone pain as an adverse effect of cyclosporin therapy for Crohn's disease

Isaacs, Kim L.

doi:10.1002/ibd.3780040205

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Cytomegalovirus (CMV) antigen was found in a peripheral blood buffy coat, and th patient's symptoms resolved within 24 hours of starting IV ganciclovir 10 mg/kg/d. Isaacs [19] described a similar clinical presentation in a patient being treated with CSA and prednisone who had a negative examination and x-ray. The patient was then treated successfully with nifedipine on the assumption that the sudden pain was caused by cortical bone vasoconstriction, as had been previously described in the renal transplantation literature.…”

Section: Short and Long-term Toxicitymentioning

confidence: 84%

Cyclosporine in inflammatory bowel disease

Kornbluth

1999

Curr Gastroenterol Rep

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For the past decade, the use of oral and intravenous cyclosporine has been examined for patients with inflammatory bowel disease who have demonstrated resistance to steroid treatment. Updated and new results from a number of studies offer short-term and long-term data on cyclosporine and its effectiveness in achieving and maintaining remission from disease. Short-term and long-term toxicity associated with cyclosporine is reviewed here, as well as quality of life among patients who have been treated successfully. Also discussed are practice patterns among clinicians using cyclosporine in its varied formulations and the appropriate settings for its use.

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Section: Short and Long-term Toxicitymentioning

confidence: 84%

Cyclosporine in inflammatory bowel disease

Kornbluth

1999

Curr Gastroenterol Rep

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“…It has been described in patients following renal transplant and other solid organ transplantation. There have also been cases described with psoriatic arthritis and Crohn's disease where cyclosporin was used [3].…”

Section: Discussionmentioning

confidence: 98%

Leg bone pain syndrome in a patient with ulcerative colitis treated with cyclosporin

2007

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“…So far, the etiology of the syndrome is still controversially discussed [36]. Of further note is the fact that bone pain syndromes caused by bone marrow edema related to cyclosporine medication have also been described in clinical settings different from transplantation [37], thus raising the probability of CNI‐medication as at least one major etiologic agent in the development of the syndrome. As the syndrome displays a benign and time‐limited course in patients with an acceptable graft function on long‐term follow up, we would only cautiously suggest conversion to a less immunosuppressive protocol.…”

Section: Discussionmentioning

confidence: 99%

Post-transplant distal limb syndrome: clinical diagnosis and long-term outcome in 37 renal transplant recipients

et al. 2008

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Summary After the introduction of steroid sparing immunosuppressive protocols, osteonecrosis of the hip has become a rare entity in renal transplantation. Instead, an elusive bilateral pain syndrome of the distal extremities has gained more clinical attention. Because of the typical presentation, it is sometimes referred to as ‘post‐transplant distal limb syndrome’ (PTDLS). The syndrome typically manifests during the first year after transplantation and may lead to significant morbidity because of pain induced immobilization. On MRI‐scans, a characteristic bilateral patchy osteoedema can be demonstrated. The etiology of PTDLS has not been determined definitely so far. Over the last 8 years, we have seen the syndrome in 37 out of 639 renal transplant patients (5.8%). There was no association to steroid‐medication, age, gender, PTH levels or delayed graft function. As an important finding, we saw a significant rise in alkaline phosphatase from 160 ± 54 to 271 ± 108 U/l (P = 0.001) and calcium from 2.46 ± 0.18 to 2.58 ± 0.18 mmol/l (P = 0.013) preceding the onset of pain by several weeks. Mean duration of clinical symptoms was 5.1 ± 3.1 months; however, all patients experienced remission without signs of chronic damage on long‐term follow up.

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Severe bone pain as an adverse effect of cyclosporin therapy for Crohn's disease

Cited by 9 publications

References 12 publications

Cyclosporine in inflammatory bowel disease

Cyclosporine in inflammatory bowel disease

Leg bone pain syndrome in a patient with ulcerative colitis treated with cyclosporin

Post-transplant distal limb syndrome: clinical diagnosis and long-term outcome in 37 renal transplant recipients

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