Highlights
- •Solid organ transplant patients who receive tacrolimus could develop a myopathy.
- •Muscle biopsy documents an inflammatory myopathy with the features of polymyositis.
- •Patients receiving tacrolimus should be made aware of muscular symptoms.
Abstract
Tacrolimus, also known as FK506, is an immunosuppressive agent widely used for the
prevention of acute allograft rejection in organ transplantation and for the treatment
of immunological diseases. This study reports two male patients who underwent solid
organ transplantation (liver and kidney). After transplant, the patients received
continuous immunosuppressive therapy with oral tacrolimus and later presented clinical
manifestations and laboratory signs of myopathy. Muscle biopsies of both patients
clearly documented an inflammatory myopathy with the histological features of polymyositis
including CD8+ T cells which invaded healthy muscle fibers and expressed granzyme B and perforin,
many CD68+ macrophages and MHC class I antigen upregulation on the surface of most fibers.
Because of the temporal association while receiving tacrolimus and since other possible
causes for myopathy were excluded, the most likely cause of polymyositis in our patients
was tacrolimus toxicity. We suggest that patients on tacrolimus should be carefully
monitored for serum CK levels and clinical signs of muscle disease.
Keywords
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Article info
Publication history
Published online: August 06, 2014
Accepted:
July 15,
2014
Received in revised form:
June 17,
2014
Received:
January 4,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
