Abstract
Three cases of insulin-requiring diabetes mellitus associated with tacrolimus (FK506) therapy in pediatric renal transplant patients are presented. New-onset diabetes mellitus has been reported with tacrolimus therapy post liver and kidney transplants in up to 12% of adult patients, but is thought to be rare in pediatrics. Although insulin requirement with tacrolimus therapy has been occasionally reported in adolescent patients post liver transplant, only a single case in a pediatric kidney transplant recipient has been previously documented. These cases illustrate the significant diabetogenic effect of tacrolimus in pediatric renal transplant patients. As the use of tacrolimus becomes more prevalent in pediatric kidney transplantation, pediatric nephrologists should be aware of this potential complication.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
U.S. Multicenter FK506 Liver Study Group (1994) A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression in liver transplantation. N Engl J Med 331:1110–1115
Jindal RM (1994) Postransplant diabetes mellitus — a review. Transplantation 58: 1289–1298
Friedman EA, Shyh T, Beyer MM, Mania T, Butt KMH (1985) Posttransplant diabetes in kidney transplant recipients. Am J Nephrol 5:196–202
Scantlebury V, Shapiro R, Fung J, Tzakis A, McCauley J, Jordan M, Jensen C, Hakala T, Simmons R, Starzl TE (1991) New onset of diabetes in FK506 vs cyclosporine-treated kidney transplant recipients. Transplant Proc 23:3169–3170
Tzakis A, Reyes J, Todo S, Nour B, Shapiro R, Jordan M, McCauley J, Armitage J, Fung JJ, Starzl TE (1993) Two year experience with FK 506 in pediatric patients. Transplant Proc 25:619–621
Klintmalm G (1994) A review of FK506: a new immunosuppressive agent for the prevention and rescue of graft rejection. Transplant Rev 8:53–63
Schneck FX, Jordan ML, Jensen CWB, Shapiro R, Tzakis A, Scantlebury V, Ellis E, Gilboa N, Simmons RL, Hakala TR, Starzl TE (1992) Pediatric renal transplantation under FK506 immunosuppression. J Urol 147:1585–1587
Ellis D, Shapiro R, Jordan ML, Scantlebury VP, Gilboa N, Hopp L, Weichler N, Tzakis AG, Simmons RL (1994) Comparison of FK-506 and cyclosporine regimens in pediatric renal transplantation. Pediatr Nephrol 8:193–200
Starzl TE, Fung J, Jordan M, Shapiro R, Tzakis A, McCauley J, Johnston H, Iwaki Y, Jain A, Alessiani M, Todo S (1990) Kidney transplantation under FK506. JAMA 264:63–67
Carroll PB, Rilo H, Reyes J, Alejandro R, Zeng Y, Ricordi C, Tzakis A, Shapiro R, Starzl TE (1991) FK506 associated diabetes mellitus in the pediatric transplant population is a rare complication. Transplant Proc 23:3171–3172
Fung J, Alessiani M, Abu-Elmage K, Todo S, Shapiro R, Tzakis A, Van Thiel D, Armitage J, Jain A, McCauley J, Selby R, Starzl TE (1991) Adverse effects associated with the use of FK506. Transplant Proc 23:3105–3108
Krentz AJ, Dousset B, Mayer D, Mcmaster P, Buckels J, Cramb R, Smith JM, Nattrass M (1993) Metabolic effects of cyclosporin A and FK506 in liver transplant recipients. Diabetes 42:1753–1759
Jindal RM (1994) Diabetogenicity of FK506 versus cyclosporine in liver transplant recipients. Transplantation 58:370–371
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Furth, S., Neu, A., Colombani, P. et al. Diabetes as a complication of tacrolimus (FK506) in pediatric renal transplant patients. Pediatr Nephrol 10, 64–66 (1996). https://doi.org/10.1007/BF00863448
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00863448