Treatment with sirolimus ameliorates tacrolimus-induced autoimmune cytopenias after solid organ transplant.

Full Abstract

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.

Author information

Author/s: Teachey, David T (DT); Jubelirer, Tracey (T); Baluarte, H Jorge (HJ); Wade, Amanda (A); Manno, Catherine S (CS);

Affiliation: Division of Hematology, Children's Hospital of Philadelphia, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. teacheyd(-atsign-)email.chop.edu

Journal and publication information

Publication Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't

Journal: Pediatric blood & cancer (Pediatr Blood Cancer), published in United States. (Language: eng)

Reference: 2009-Dec; vol 53 (issue 6) : pp 1114-6

Dates: Created 2009/09/16; Completed 2009/10/13;

PMID: 19621445, status: MEDLINE (last retrieval date: 10/13/2009, IMS Date: )

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