Neuropsychologic side-effects of tacrolimus in pediatric renal transplantation.
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Neuropsychologic side-effects of tacrolimus in pediatric renal transplantation. / Kemper, Markus J.; Spartà, Giuseppina; Laube, Guido F; Miozzari, Marco; Neuhaus, Thomas J.
in: CLIN TRANSPLANT, Jahrgang 17, Nr. 2, 2, 2003, S. 130-134.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Neuropsychologic side-effects of tacrolimus in pediatric renal transplantation.
AU - Kemper, Markus J.
AU - Spartà, Giuseppina
AU - Laube, Guido F
AU - Miozzari, Marco
AU - Neuhaus, Thomas J
PY - 2003
Y1 - 2003
N2 - Calcineurin inhibition with tacrolimus has been used after renal transplantation (RTPL) as rescue therapy for insufficient immunological control or if cyclosporin A (CSA) toxicity occurred. Neurologic side-effects occur but are rare in children, usually presenting as tremor; however, serious complications, e.g. the posterior leukoencephalopathy syndrome are also documented. Twenty children (10 girls) were switched to tacrolimus: 11 (55%) for immunological reasons (n = 9: steroid-resistant rejection; n = 2: recurrent rejections) and nine for CSA side-effects. Tacrolimus was started at a median of 8 wk (range 10 d to 8.7 yr) after RTPL and was continued for a median of 2.5 yr (range 5 wk to 4.6 yr). Renal function significantly improved over a period of 12 months following conversion to tacrolimus (glomerular filtration rate 56 +/- 19 vs. 66 +/- 16 mL/min/1.73 m2; p < 0.03; n = 13). Fifteen of 20 (75%) patients tolerated tacrolimus well. The most frequent side-effects were neuropsychological and behavioral symptoms in three children, ranging from anorexia nervosa-like symptoms with weight loss, amenorrhea, depression and school problems to severe insomnia and to aggressive and anxious behavior in one child. Only the latter child was exposed to toxic tacrolimus blood levels. All side-effects were fully reversible after discontinuation of tacrolimus. In conclusion, tacrolimus had a beneficial effect on renal function and was well tolerated in the majority of pediatric patients. However, neuropsychologic and behavioral side-effects are important and maybe underrecognized in children.
AB - Calcineurin inhibition with tacrolimus has been used after renal transplantation (RTPL) as rescue therapy for insufficient immunological control or if cyclosporin A (CSA) toxicity occurred. Neurologic side-effects occur but are rare in children, usually presenting as tremor; however, serious complications, e.g. the posterior leukoencephalopathy syndrome are also documented. Twenty children (10 girls) were switched to tacrolimus: 11 (55%) for immunological reasons (n = 9: steroid-resistant rejection; n = 2: recurrent rejections) and nine for CSA side-effects. Tacrolimus was started at a median of 8 wk (range 10 d to 8.7 yr) after RTPL and was continued for a median of 2.5 yr (range 5 wk to 4.6 yr). Renal function significantly improved over a period of 12 months following conversion to tacrolimus (glomerular filtration rate 56 +/- 19 vs. 66 +/- 16 mL/min/1.73 m2; p < 0.03; n = 13). Fifteen of 20 (75%) patients tolerated tacrolimus well. The most frequent side-effects were neuropsychological and behavioral symptoms in three children, ranging from anorexia nervosa-like symptoms with weight loss, amenorrhea, depression and school problems to severe insomnia and to aggressive and anxious behavior in one child. Only the latter child was exposed to toxic tacrolimus blood levels. All side-effects were fully reversible after discontinuation of tacrolimus. In conclusion, tacrolimus had a beneficial effect on renal function and was well tolerated in the majority of pediatric patients. However, neuropsychologic and behavioral side-effects are important and maybe underrecognized in children.
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Child
KW - Drug Resistance
KW - Kidney Transplantation
KW - Immunosuppressive Agents/adverse effects
KW - Weight Loss
KW - Abdominal Pain/chemically induced
KW - Aggression
KW - Amenorrhea/chemically induced
KW - Child Behavior Disorders/chemically induced
KW - Cyclosporine/adverse effects
KW - Depression/chemically induced
KW - Diabetes Mellitus/chemically induced
KW - Gingival Hyperplasia/chemically induced
KW - Graft Rejection/prevention & control
KW - Hypertrichosis/chemically induced
KW - Kidney Diseases/chemically induced
KW - Sleep Initiation and Maintenance Disorders/chemically induced
KW - Tacrolimus/adverse effects
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Child
KW - Drug Resistance
KW - Kidney Transplantation
KW - Immunosuppressive Agents/adverse effects
KW - Weight Loss
KW - Abdominal Pain/chemically induced
KW - Aggression
KW - Amenorrhea/chemically induced
KW - Child Behavior Disorders/chemically induced
KW - Cyclosporine/adverse effects
KW - Depression/chemically induced
KW - Diabetes Mellitus/chemically induced
KW - Gingival Hyperplasia/chemically induced
KW - Graft Rejection/prevention & control
KW - Hypertrichosis/chemically induced
KW - Kidney Diseases/chemically induced
KW - Sleep Initiation and Maintenance Disorders/chemically induced
KW - Tacrolimus/adverse effects
M3 - SCORING: Journal article
VL - 17
SP - 130
EP - 134
JO - CLIN TRANSPLANT
JF - CLIN TRANSPLANT
SN - 0902-0063
IS - 2
M1 - 2
ER -
