|
KMID : 0869620140310050992
|
|
Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 5 p.992 ~ p.1000
|
|
|
Improvement of Glycemic Control after Conversion from Tacrolimus to Cyclosporine A in Liver Transplanted Patient with Hepatitis C Virus Reinfection : Case Report
|
|
Kim Sun-Yi
Sung Ji-Yeon
Kim Eon-Young
Moon Bo-Kyung
|
|
|
Abstract
|
|
|
|
Tacrolimus (FK, FK506) and cyclosporine A (CsA) are principal immunosuppressive agents given to solid organ transplant recipients to prevent and treat allograft rejection. Post transplant diabetes mellitus (PTDM) is a new onset diabetes in transplanted patients without previous history of diabetes mellitus. Incidence rate of PTDM appears to be higher in hepatitis C virus (HCV) positive recipients than in HCV negative recipients. CsA may provide reduced incidence of PTDM and improve responses to antiviral therapy compared to FK506. A 60 year old male patient obtained liver transplant from his son on July 27th 2012 due to hepatocellular carcinoma and C viral liver cirrhosis. He had normal fasting blood glucose (FBG) level before liver transplantation (LT). About 5 months after LT, he was diagnosed with diabetes mellitus with reinfection of HCV. On December 31st 2012, he was admitted to emergency room in hyperglycemic hyperosmolar state (HHS). FK506 was switched to CsA. Neutral protamine hagedorn (NPH) was initiated. Peginterferon (Peg-IFN) α-2a 180 mcg/week was added. After conversion, his FBG levels were progressively decreased. He achieved partial early virological response (pEVR) at week 12 of antiviral therapy. Since May 2013, NPH has been discontinued. He maintained normal FBG without insulin. Relationships existed among HCV infection, PTDM, and choice of immunosuppression are complex. Switching from FK506 to CsA in liver transplant recipients developed PTDM with HCV reinfection may be an effective treatment strategy to improve glycemic control at least during antiviral therapy.
|
|
|
KEYWORD
|
|
|
Liver Transplantation (LT), Hepatitis C Virus (HCV), Cyclosporine A, Tacrolimus, Diabetes Mellitus (DM)
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|