Resolution of Severe Atopic Dermatitis after Tacrolimus Withdrawal

Cell Transplantation

Case Study

Antonello Pileggi¹  Paolo Romanelli²  Pablo Cure³  David A. Baidal³  Raffaella Poggioli³  Gaston M. Ponte³  Camillo Ricordi⁴  Tatiana Froud⁴  Gennaro Selvaggi⁴  Raquel N. Faradji⁵  Rodolfo Alejandro⁵ 

[1] DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, 33136, USA;Diabetes Research Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;Diabetes Research Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;Diabetes Research Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA;

关键词: Atopic dermatitis;    Alopecia areata;    Diabetes;    Immunosuppression;    Islet transplantation;    Tacrolimus;   

DOI  :  10.3727/000000007783464524

 received in 2006-10-05, accepted in 2006-10-16,  发布年份 2007

来源: Sage Journals

【 摘 要 】

Tacrolimus is an immunosuppressive agent used in solid organ and islet transplantation. Its topical form has shown benefit in the treatment of inflammatory skin conditions. Although tacrolimus has a wide spectrum of side effects, dermatological complications related to systemic tacrolimus therapy are limited in the literature. Atopic dermatitis (AD) is a chronic pruritic cutaneous condition that usually begins in infancy and is characterized by an increased Th2 response. We report the case of a patient with type 1 diabetes mellitus (T1DM) and history of AD latent for 10 years who developed severe dermatitis and alopecia 5 months after undergoing allogeneic islet transplantation and initiating a steroid-free immunosuppressive regimen with sirolimus and tacrolimus maintenance. After exclusion of other possible causes for the progression and exacerbation of the clinical presentation of AD, discontinuation of tacrolimus and introduction of mycophe-nolate mofetil resulted in full remission of the symptoms. The beneficial effects of tacrolimus withdrawal suggest a cause–effect relationship between this adverse event and the utilization of the drug. Islet graft function remained stable after modification of the therapeutic regimen (stable glycemic control and unchanged C-peptide).

【 授权许可】

Unknown   
© 2007 Cognizant Comm. Corp.