Beaufils H, de Groc F, Gubler M C, Wechsler B, Le Hoang P, Baumelou A, Chomette G, Jacobs C
INSERM U. 192, Hôpital Necker Enfants Malades, Paris, France.
Clin Nephrol. 1990 Oct;34(4):157-62.
Hemolytic uremic syndrome (HUS) has been reported in patients treated with cyclosporin A (CsA) following bone, hepatic and kidney transplantation. We report two patients with Behçet's disease (BD) under CsA treatment because of severe uveitis, who developed HUS several months after the initiation of treatment. Renal biopsies showed lesions consistent with the diagnosis of the arterial form of thrombotic microangiopathy: vascular thrombosis with extensive glomerular ischemia. Renal failure persisted after withdrawal of CsA: one patient is in chronic renal failure (CRF) with a 4-year follow-up; the other died after refusal of chronic hemodialysis. In our two patients, excessive doses of CsA with high trough levels are likely to have contributed to the development of HUS. A rapid adjustment of CsA doses and an early detection of signs of the microangiopathic process might have prevented this severe complication of CsA treatment.
已有报告称，在接受骨、肝和肾移植的患者中，使用环孢素A（CsA）治疗后出现了溶血性尿毒症综合征（HUS）。我们报告了两名患有白塞病（BD）的患者，因严重葡萄膜炎接受CsA治疗，在治疗开始数月后发生了HUS。肾活检显示病变符合动脉型血栓性微血管病的诊断：血管血栓形成伴广泛的肾小球缺血。停用CsA后肾衰竭仍持续存在：一名患者在随访4年后处于慢性肾衰竭（CRF）状态；另一名患者在拒绝接受慢性血液透析后死亡。在我们的两名患者中，高谷浓度的过量CsA剂量可能促成了HUS的发生。快速调整CsA剂量并早期发现微血管病变过程的迹象可能会预防CsA治疗的这种严重并发症。
