Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report
Managing kidney transplant recipients during pregnancy presents significant challenges, particularly in balancing the interactions and safety concerns of immunosuppressive medications such as mycophenolate mofetil and tacrolimus. Pregnancy can affect tacrolimus levels, and its safety profile during...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-02-01
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| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X251317913 |
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| author | Ahmad Matarneh Ravi chokshi Sundus Sardar Dinia Salmeron James O’brien Fareeha Khalil Naman Trivedi Nasrollah Ghahramani Vaqar Shah |
| author_facet | Ahmad Matarneh Ravi chokshi Sundus Sardar Dinia Salmeron James O’brien Fareeha Khalil Naman Trivedi Nasrollah Ghahramani Vaqar Shah |
| author_sort | Ahmad Matarneh |
| collection | DOAJ |
| description | Managing kidney transplant recipients during pregnancy presents significant challenges, particularly in balancing the interactions and safety concerns of immunosuppressive medications such as mycophenolate mofetil and tacrolimus. Pregnancy can affect tacrolimus levels, and its safety profile during pregnancy remains underexplored. When the patient also hasa human immunodeficiency virus, management becomes even more complicated due to potential interactions between antiretrovirals and immunosuppressants. Notably, tacrolimus is highly susceptible to drug-drug interactions. Even minor adjustments in highly active antiretroviral therapy can result in significant fluctuations in tacrolimus levels, potentially leading to subtherapeutic concentrations (increasing the risk of rejection) or supratherapeutic levels with toxicity. Tacrolimus toxicity is often managed by administering cytochrome P450 enzyme inducers, with the choice of agent depending on factors such as the degree of enzyme induction. Agents such as isoniazid or rifampicin are typically considered. In this case report, we described the treatment of tacrolimus toxicity with rifampicin in a pregnant kidney transplant recipient with a newly diagnosed human immunodeficiency virus infection. |
| format | Article |
| id | doaj-art-114a98c34f0e490996783755e6186308 |
| institution | Kabale University |
| issn | 2050-313X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj-art-114a98c34f0e490996783755e61863082025-02-03T10:04:04ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-02-011310.1177/2050313X251317913Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case reportAhmad Matarneh0Ravi chokshi1Sundus Sardar2Dinia Salmeron3James O’brien4Fareeha Khalil5Naman Trivedi6Nasrollah Ghahramani7Vaqar Shah8Department of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Maternal-Fetal Medicine, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Maternal-Fetal Medicine, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Maternal-Fetal Medicine, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Nephrology, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USAManaging kidney transplant recipients during pregnancy presents significant challenges, particularly in balancing the interactions and safety concerns of immunosuppressive medications such as mycophenolate mofetil and tacrolimus. Pregnancy can affect tacrolimus levels, and its safety profile during pregnancy remains underexplored. When the patient also hasa human immunodeficiency virus, management becomes even more complicated due to potential interactions between antiretrovirals and immunosuppressants. Notably, tacrolimus is highly susceptible to drug-drug interactions. Even minor adjustments in highly active antiretroviral therapy can result in significant fluctuations in tacrolimus levels, potentially leading to subtherapeutic concentrations (increasing the risk of rejection) or supratherapeutic levels with toxicity. Tacrolimus toxicity is often managed by administering cytochrome P450 enzyme inducers, with the choice of agent depending on factors such as the degree of enzyme induction. Agents such as isoniazid or rifampicin are typically considered. In this case report, we described the treatment of tacrolimus toxicity with rifampicin in a pregnant kidney transplant recipient with a newly diagnosed human immunodeficiency virus infection.https://doi.org/10.1177/2050313X251317913 |
| spellingShingle | Ahmad Matarneh Ravi chokshi Sundus Sardar Dinia Salmeron James O’brien Fareeha Khalil Naman Trivedi Nasrollah Ghahramani Vaqar Shah Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report SAGE Open Medical Case Reports |
| title | Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report |
| title_full | Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report |
| title_fullStr | Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report |
| title_full_unstemmed | Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report |
| title_short | Tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus: A case report |
| title_sort | tacrolimus toxicity management in a pregnant kidney transplant recipient with newly diagnosed human immunodeficiency virus a case report |
| url | https://doi.org/10.1177/2050313X251317913 |
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