A case report of tigecycline induced acute pancreatitis in a renal transplant patient and review of the literature: Should we avoid tigecycline in patients on calcineurin inhibitors?

Autor: Yazirli B; Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Kara E; Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Turkey., Inkaya AC; Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Maden S; Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Ozberk U; Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Yildirim T; Division of Nephrology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Parlak E; Division of Gastroenterology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Uzun O; Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Yilmaz SR; Division of Nephrology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Arici M; Division of Nephrology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2021 Aug; Vol. 23 (4), pp. e13593. Date of Electronic Publication: 2021 Mar 11.
DOI: 10.1111/tid.13593
Abstrakt: Tigecycline has been approved by the US (United States) Food and Drug Administration in a variety of complicated infections due to its broad-spectrum antibiotic activity. Following phase III trials, the product label was revised and acute pancreatitis was listed as an adverse effect. Its safety profile in special groups such as renal transplant patients is not exactly known. We report the first case of unintentional rechallenge of tigecycline induced pancreatitis in a renal transplant patient. Ten days following the renal transplantation, a 35-year-old patient presented to the clinic with acute rejection. He received anti-thymocyte globulin (ATG) and pulse steroid treatments for rejection. Following the treatment, he developed perianal cellulitis and tigecycline was started. Nine days following initiation of tigecycline he received thrombectomy for his incidental cardiac thrombus. One day after thrombectomy, he developed acute pancreatitis (AP). Thrombectomy was suspected to be the cause of AP. During hospitalization for transplant rejection, tigecycline was re-started for a newly developed complicated abdominal infection. On the third day of the tigecycline re-treatment, he developed a second episode of AP. Following tigecycline withdrawal, his symptoms resolved and serum pancreatic enzymes returned to normal, thus AP was ultimately attributed to tigecycline. This lethal side effect should be kept in mind while treating severe infections in renal transplant recipients.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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