Multiple Adverse Drug Reactions to Calcineurin Inhibitors in a Renal Transplant Patient

Calcineurin inhibitors (CNIs) are typically used to prevent organ rejection and their use has significantly improved allograft and survival rates with a marked reduction in rejection rates. However, CNIs have been associated with various side effects including nephrotoxicity, hypertension, gingival...

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Bibliographic Details
Published in:Uro 2021-08, Vol.1 (3), p.180-186
Main Authors: Ahmed, Raheel, Hassan, Zair, Haseeb, Abdul, Masood, Aysha, Ali, Iftikhar
Format: Article
Language:English
Subjects:
Blood
calcineurin inhibitors
Creatinine
Drug dosages
facial palsy
gingival hyperplasia
Hair
Hyperplasia
Hypertension
hypertrichosis
Kidney transplants
Laboratories
Oral hygiene
Patients
renal transplantation
Tremor (Muscular contraction)
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Summary:Calcineurin inhibitors (CNIs) are typically used to prevent organ rejection and their use has significantly improved allograft and survival rates with a marked reduction in rejection rates. However, CNIs have been associated with various side effects including nephrotoxicity, hypertension, gingival hyperplasia, hypertrichosis, hepatotoxicity, hyperkalemia, and neurotoxicity. Significant intra-patient and interpatient pharmacokinetic variability and narrow therapeutic indices make the therapy complicated. Although CNIs are essential in preventing organ rejection, higher doses could lead to toxicity, which can reduce patient tolerability and negatively affect long-term allograft survival and patient mortality. As individual patients respond differently to comparable drug levels, attaining the optimal drug level range does not ensure lack of drug toxicity or complete immunosuppressant viability. One to two adverse effects are commonly observed in patients using CNIs. However, no case about CNI-induced gingival hyperplasia, hypertrichosis, tremors, facial nerve palsy, and blepharospasm after kidney transplantation in a single patient has been reported. Our report describes the unusual case of a patient presenting with CNI-induced multiple adverse reactions.
ISSN:2673-4397
2673-4397
DOI:10.3390/uro1030018