Nasr Ranim Y, Othman Maram Al
Department of Radiology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Radiology, King Faisal Specialist Hospital and Research center, Riyadh, Saudi Arabia.
Radiol Case Rep. 2024 Jul 8;19(9):4024-4028. doi: 10.1016/j.radcr.2024.06.015. eCollection 2024 Sep.
Calcineurin inhibitor-induced pain syndrome is a rare but debilitating complication of organ transplantation. This case report describes a man in his forties who developed bilateral hip pain, an atypical presentation of calcineurin inhibitor-induced pain syndrome, after undergoing renal transplantation. Initially, avascular necrosis was suspected as a potential cause of pain. The initial radiographs revealed no abnormalities. However, high trough levels of calcineurins and subsequent magnetic resonance imaging of the hip revealed bilateral symmetric bone marrow edema, which was consistent with calcineurin inhibitor-induced pain syndrome. Adjustments made to the immunosuppressive regimen and multidisciplinary management resulted in an improvement in the patient's symptoms. This case report emphasizes the importance of adopting a comprehensive approach to post-transplantation pain management. Moreover, this report emphasizes the importance of considering the diagnosis of calcineurin inhibitor-induced pain syndrome while investigating and managing post-transplantation patients presenting with hip pain. Clinicians need a high index of suspicion for calcineurin inhibitor-induced pain syndrome, thereby contributing to enhanced post-transplantation care and outcomes while improving the quality of life of transplant recipients experiencing musculoskeletal pain.
钙调神经磷酸酶抑制剂诱导的疼痛综合征是器官移植中一种罕见但使人衰弱的并发症。本病例报告描述了一名四十多岁的男性,在接受肾移植后出现双侧髋部疼痛,这是钙调神经磷酸酶抑制剂诱导的疼痛综合征的一种非典型表现。最初,怀疑缺血性坏死是疼痛的潜在原因。最初的X线片未显示异常。然而,钙调神经磷酸酶的高谷值水平以及随后的髋部磁共振成像显示双侧对称性骨髓水肿,这与钙调神经磷酸酶抑制剂诱导的疼痛综合征相符。对免疫抑制方案的调整和多学科管理使患者症状得到改善。本病例报告强调了采用综合方法进行移植后疼痛管理的重要性。此外,本报告强调在对出现髋部疼痛的移植后患者进行调查和管理时,考虑钙调神经磷酸酶抑制剂诱导的疼痛综合征诊断的重要性。临床医生对钙调神经磷酸酶抑制剂诱导的疼痛综合征需要有高度的怀疑指数,从而有助于加强移植后护理和改善结果,同时提高经历肌肉骨骼疼痛的移植受者的生活质量。