Tacrolimus pain syndrome in renal transplant patients: report of two cases

Franco, Michel; Blaimont, Aude; Albano, Laetitia; Bendini, C.; Cassuto, Élisabeth; Jaeger, Philippe

doi:10.1016/s1297-319x(03)00095-2

Cited by 22 publications

(17 citation statements)

References 8 publications

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“…10,15-17 However, magnetic resonance imaging of the affected area commonly shows bone marrow ede-ma. 8,9,15,16,18 In our patient, there was mild signal abnormality in the epiphyses around the knees that may have represented bone marrow edema, but it was not as prominent as cases illustrated in the literature. 8, 19 What was most striking in our patient was the presence of high signal intensity in the periosteal regions of the femora and tibiae, a finding not highlighted previously in the literature but one that has been shown to accompany bone marrow edema.…”

Section: Discussioncontrasting

confidence: 58%

Cyclosporine-Induced Pain Syndrome in a Child Undergoing Hematopoietic Stem Cell Transplant

et al. 2009

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Section: Discussioncontrasting

confidence: 58%

Cyclosporine-Induced Pain Syndrome in a Child Undergoing Hematopoietic Stem Cell Transplant

et al. 2009

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“…Moreover, TRPC1, TRPC3, TRPC5, and TRPC6 were reported to be expressed in sensory neurons [50,51]. Furthermore, TRP channels as well as other channels could underlie [Ca 2+ ] i changes induced by FK506, since some reports indicated that calcineurin inhibitors might modulate [Ca 2+ ] i changes through the interaction with voltage-gated calcium channels, ryanodine receptors and IP 3 receptors (50,51,52,53,54). In this study, we found that FK506induced [Ca 2+ ] i increases were completely abolished when there was no extracellular Ca 2+ (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Many reports have demonstrated that FK506 induces chronic pain in humans, and its interacting proteins (FKBP and calcineurin) could be involved in chronic pain. Chronic pain was observed in transplant patients treated with calcineurin inhibitors [52,53]. Knockdown of FKBP51 reduced pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) and NGF in DRG in a chronic constriction injury (CCI) model of rats [54], but it did not affect acute pain [55].…”

Section: Discussionmentioning

confidence: 99%

FK506 (tacrolimus) causes pain sensation through the activation of transient receptor potential ankyrin 1 (TRPA1) channels

et al. 2018

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FK506 (tacrolimus) is an immunosuppressant widely used as an ointment in the treatment of atopic dermatitis. However, local application of FK506 can evoke burning sensations in atopic dermatitis patients, and its mechanisms are unknown. In this study, we found that FK506 activates transient receptor potential ankyrin 1 (TRPA1) channels. In Ca 2+ -imaging experiments, increases in intracellular Ca 2+ concentrations ([Ca 2+ ] i ) by FK506 were observed in HEK293T cells expressing hTRPA1 or hTRPM8. FK506-induced currents were observed in HEK293T cells expressing hTRPA1 or mTRPA1, but less or not at all in cells expressing hTRPV1 or hTRPM8 using a patch-clamp technique. FK506 also evoked single-channel opening of hTRPA1 in an inside-out configuration. FK506-induced [Ca 2+ ] i increases were also observed in TRPA1-expressing mouse primary sensory neurons. Furthermore, injection of FK506 evoked licking or biting behaviors and these behaviors were almost abolished in TRPA1 knockout mice. These results indicate that FK506 might cause pain sensations through TRPA1 activation.

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“…Pain after transplantation is most frequently caused by osteoporosis due to immunosuppressive therapy with corticosteroids (Collini et al, 2006;Franco et al, 2004). However, studies have demonstrated that long-term calcineurin inhibitors (CNIs), such as cyclosporine and The patient first underwent core decompression of the left femoral head using a fibula bone grafting and subsequently underwent right total hip replacement for avascular necrosis (AVN) 3 months after the first surgery tacrolimus, influence bone metabolism and decrease blood flow in the bone, which results in bony pain and osteonecrosis of the hip (Grotz et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Bone infarction of the hip after hand allotransplantation: A case report

et al. 2018

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Vascularized composite allotransplantation represents as an emerging field in reconstructive surgery. However, some complications can be associated with the procedure. The authors describe a case of bone infarctions of the bilateral hip joints following the first hand allotransplantation in Taiwan. A 45‐year‐old man who experienced a traumatic amputation of the distal third of his forearm received a hand transplantation from a brain‐dead donor. Immunosuppression included antithymocyte globulins, and bolus methylprednisolone (Solu‐Medrol) was used for the induction. The maintenance therapy protocol included systemic tacrolimus, mycophenolate mofetil, and prednisone. The patient discontinued the systemic steroid 15 months after surgery. Two episodes of acute rejections were observed at 105 and 810 days after surgery. These signs disappeared after pulse therapy with Solu‐Medrol, titration with tacrolimus, and topical immunosuppressive creams (tacrolimus and clobetasol). However, the patient felt pain in both hips after long periods of standing 30 months after the transplantation. A pelvic radiograph and magnetic resonance imaging revealed avascular necrosis (AVN) in both hip joints. Because of the progressive worsening of the pain, the patient underwent a decompression surgery on the left hip involving a fibula bone graft. The patient underwent a right hip hemi‐arthroplasty with a bipolar prosthesis 3 months later. The patient remained in good health without major complications. These findings indicate that systemic steroids and tacrolimus might be the major predisposing factors for the induction of AVN after hand allotransplantation.

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Tacrolimus pain syndrome in renal transplant patients: report of two cases

Cited by 22 publications

References 8 publications

Cyclosporine-Induced Pain Syndrome in a Child Undergoing Hematopoietic Stem Cell Transplant

Cyclosporine-Induced Pain Syndrome in a Child Undergoing Hematopoietic Stem Cell Transplant

FK506 (tacrolimus) causes pain sensation through the activation of transient receptor potential ankyrin 1 (TRPA1) channels

Bone infarction of the hip after hand allotransplantation: A case report

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