Department of Pharmacy, China-Japan Union Hospital, Jilin University, Changchun, China.
Department of Pharmacy, The First Hospital, Jilin University, Changchun, China.
J Clin Pharm Ther. 2020 Dec;45(6):1497-1500. doi: 10.1111/jcpt.13238. Epub 2020 Aug 17.
Tacrolimus (FK506), an immunosuppressant, is a popular option for combination drug treatment of nephrotic syndrome. It is well-tolerated by most patients and rarely induces anaemia. We report a case of anaemia in a girl with immunoglobulin A (IgA) nephropathy that occurred after FK506 treatment.
A 12-year-old girl received a combination treatment of FK506 and hormones. During the therapy, the red blood cells (RBCs), haemoglobin (HGB) and red blood cell-specific volume (HCT) continued to decrease following an increase in the whole blood concentration of FK506. Moderate anaemia was found in the patient. The levels of RBC, HGB and HCT gradually improved after discontinuation of the FK506 and symptomatic treatment.
The mechanism by which FK506 induces anaemia remains unclear. The genetic polymorphisms of CYP3A5 or the chemical structure may have an effect in the onset of the disease. Thus, when a patient presents with a newly developed anaemic condition during FK506 treatment, after elimination of haematuria and any underlying disease, the possibility of the effect of the medication should be considered.
他克莫司（FK506）是一种免疫抑制剂，常用于肾病综合征的联合药物治疗。它通常被大多数患者耐受，很少引起贫血。我们报告了一例 IgA 肾病患者在 FK506 治疗后发生贫血的病例。
一名 12 岁女孩接受了 FK506 和激素的联合治疗。在治疗过程中，随着全血 FK506 浓度的增加，红细胞（RBC）、血红蛋白（HGB）和红细胞比容（HCT）持续下降。患者出现中度贫血。停用 FK506 和对症治疗后，RBC、HGB 和 HCT 水平逐渐改善。
FK506 引起贫血的确切机制尚不清楚。CYP3A5 的遗传多态性或化学结构可能在疾病发生中起作用。因此，当患者在 FK506 治疗期间出现新的贫血情况，且排除血尿和任何潜在疾病后，应考虑药物的影响。
