PMID- 24182827
OWN - NLM
STAT- MEDLINE
DCOM- 20140616
LR  - 20211203
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 45
IP  - 9
DP  - 2013 Nov
TI  - Painful crural ulcerations and proteinuria as complications after several years 
      of therapy with mTOR inhibitors in the renal allograft recipient: a case report.
PG  - 3418-20
LID - S0041-1345(13)00713-6 [pii]
LID - 10.1016/j.transproceed.2013.06.002 [doi]
AB  - BACKGROUND: Proliferation signal inhibitors (mammalian target of rapamycin 
      [mTOR]) are a class of immunosuppressive drugs with a new mechanism of action and 
      safety profile, different form calcineurin inhibitors. However, their use is 
      limited because of an high incidence of adverse reactions, the majority of which 
      occur within the first 6 months after commencing treatment. In this paper, we 
      report a patient with substantial proteinuria and painful crural ulcerations that 
      appeared after a few years of mTOR inhibitor therapy and necessitated their 
      withdrawal. CASE REPORT: A 43-year-old man who received a cadaveric kidney was 
      converted to sirolimus from cyclosporine after being diagnosed with 
      adenocarcinoma and carcinoma clarocellulare of his own removed cystic kidney. 
      After 5.5 years of fairly good tolerance of the treatment, proteinuria and 
      painful crural ulcerations appeared. Because of the progressive character of the 
      adverse reactions and no satisfactory results of the applied treatment, mTOR 
      therapy was discontinued. Proteinuria was reduced, pain improved, and the 
      ulcerations healed. CONCLUSIONS: This case report indicates that adverse 
      reactions may develop as a result of mTOR inhibitor use even after many years of 
      good tolerance of the drug and they may necessitate its withdrawal.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Jozwiak, L
AU  - Jozwiak L
AD  - Department of Nephrology, Medical University, Lublin, Poland. Electronic address: 
      lucyna.jozwiak@interia.pl.
FAU - Ksiazek, A
AU  - Ksiazek A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunosuppressive Agents)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - *Kidney Transplantation
MH  - Leg Ulcer/*chemically induced
MH  - Male
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - Transplantation, Homologous
EDAT- 2013/11/05 06:00
MHDA- 2014/06/17 06:00
CRDT- 2013/11/05 06:00
PHST- 2013/04/27 00:00 [received]
PHST- 2013/06/28 00:00 [accepted]
PHST- 2013/11/05 06:00 [entrez]
PHST- 2013/11/05 06:00 [pubmed]
PHST- 2014/06/17 06:00 [medline]
AID - S0041-1345(13)00713-6 [pii]
AID - 10.1016/j.transproceed.2013.06.002 [doi]
PST - ppublish
SO  - Transplant Proc. 2013 Nov;45(9):3418-20. doi: 10.1016/j.transproceed.2013.06.002.