Nazer H, al-Sabban E, Harfi H, Antonius J, da Cunha A M
Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
J Gastroenterol Hepatol. 1992 May-Jun;7(3):257-9. doi: 10.1111/j.1440-1746.1992.tb00975.x.
Immunosuppressive regimens are usually required for patients receiving organ transplants. The development of a post-transplant lymphoproliferative disorder is an infrequent complication of such therapy. FK 506 is a new immunosuppressant agent that has recently been used in patients receiving organ transplantation. This report describes a 20 month old Saudi child who developed post-transplant lymphoproliferative disorder while receiving FK 506 following liver transplantation. Such a complication has been recognized with cyclosporine but has not been well addressed as yet with FK 506. The child also developed progressive renal complications. There was also a difficulty in interpreting the results for IgM antibodies to different viruses. The overall features of progressive renal toxicity and those of lymphadenopathy, hepatosplenomegaly, fever, neutropenia and thrombocytopenia reversed following discontinuation of FK 506 therapy. It is concluded that all the above complications, though reversible, may well be linked to the new immunosuppressant agent FK 506.
接受器官移植的患者通常需要免疫抑制方案。移植后淋巴细胞增生性疾病是此类治疗中一种罕见的并发症。FK 506是一种新型免疫抑制剂，最近已用于接受器官移植的患者。本报告描述了一名20个月大的沙特儿童，在肝移植后接受FK 506治疗期间发生了移植后淋巴细胞增生性疾病。这种并发症已被认为与环孢素有关，但FK 506尚未得到很好的解决。该儿童还出现了进行性肾脏并发症。此外，在解释针对不同病毒的IgM抗体结果时也存在困难。停用FK 506治疗后，进行性肾毒性以及淋巴结病、肝脾肿大、发热、中性粒细胞减少和血小板减少的总体特征均得到逆转。得出的结论是，所有上述并发症虽然是可逆的，但很可能与新型免疫抑制剂FK 506有关。
