Bending J J, Ogg C S, Viberti G C
Br Med J (Clin Res Ed). 1987 Feb 14;294(6569):401-2. doi: 10.1136/bmj.294.6569.401.
A young woman given a renal allograft for polycystic kidney disease developed insulin dependent diabetes mellitus 25 days after transplantation. There was no family history of diabetes, plasma glucose concentrations had been normal at presentation and on five subsequent occasions, and at no time were islet cell antibodies detectable. Plasma C peptide concentrations, however, were greatly suppressed after transplantation and remained so for up to six months. The immunosuppressive regimen had included cyclosporin A, which had been difficult to regulate and caused definite signs of toxicity in the patient. By virtue of its reported toxicity for beta cells and the reversal of the diabetes several months after the dose was reduced cyclosporin was incriminated as the probable causative agent. Dose related beta cell toxicity of cyclosporin A may be a risk in recipients of this drug and warrants careful monitoring of drug and glucose concentrations.
一名因多囊肾病接受肾移植的年轻女性在移植后25天出现胰岛素依赖型糖尿病。其家族无糖尿病病史，就诊时及随后五次检查血浆葡萄糖浓度均正常，且从未检测到胰岛细胞抗体。然而，移植后血浆C肽浓度大幅降低，并持续了长达六个月。免疫抑制方案包括环孢素A，该药物难以调节剂量，且在患者身上出现了明确的毒性迹象。鉴于环孢素A对β细胞的已知毒性以及在减少剂量数月后糖尿病得到逆转，环孢素被认为是可能的致病因素。环孢素A与剂量相关的β细胞毒性可能是使用该药物的接受者面临的一个风险，需要仔细监测药物和葡萄糖浓度。
