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Fever of unknown origin in renal transplant patients with tacrolimus

Kathrin Hochegger1, Michael Rudnicki, Martin Auinger

  • 1Clinical Division of Nephrology, Innsbruck Medical University, Innsbruck, Austria.

Clinical Transplantation
|February 5, 2009
PubMed

Insights

Tacrolimus, an immunosuppressant, can cause drug-induced fever in kidney transplant patients. Switching to cyclosporine A resolved the fever, suggesting tacrolimus as the cause.

Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Tacrolimus is a crucial immunosuppressive drug for preventing rejection in kidney transplant recipients.
  • Drug-induced fever is a potential adverse effect of various medications, including immunosuppressants.

Purpose of the Study:

  • To report and characterize drug-induced fever in renal allograft recipients caused by tacrolimus.
  • To highlight the importance of considering tacrolimus-induced fever in the differential diagnosis of fever of unknown origin post-transplant.

Main Methods:

  • Case series reporting on three renal transplant recipients who developed fever.
  • Exclusion of other causes of fever, including infection and autoimmune conditions.
  • Observation of fever resolution after discontinuation of tacrolimus and initiation of cyclosporine A.

Main Results:

  • Three patients developed fever between one and five months post-renal transplantation.
  • Infections, autoimmune diseases, and other causes were ruled out.
  • Fever resolved within 24 hours after switching from tacrolimus to cyclosporine A.

Conclusions:

  • Tacrolimus can induce drug fever in renal transplant recipients.
  • Tacrolimus-induced drug fever should be considered in the differential diagnosis of unexplained fever after kidney transplantation.
  • Cyclosporine A served as a viable alternative, leading to rapid fever resolution.

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