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Murine Full-thickness Skin Transplantation

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Published on: January 2, 2017

Growth failure associated with sirolimus: case report.

Gloria A Rangel¹, Gema Ariceta

¹Division of Pediatric Nephrology, Hospital de Cruces, Baracaldo, Vizcaya, Spain.

Pediatric Nephrology (Berlin, Germany)

|June 5, 2009

Summary

This summary is machine-generated.

Sirolimus (SRL) treatment in a pediatric renal transplant recipient was linked to significant linear growth failure. Careful monitoring of growth is crucial for pediatric transplant patients receiving SRL.

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Area of Science:

Pediatric Nephrology
Transplantation Immunology
Pharmacology

Background:

A pediatric renal transplant recipient experienced acute renal failure due to calcineurin inhibitor-related hemolytic uremic syndrome.
Cyclosporine A was replaced with sirolimus (SRL) to manage the condition and maintain graft function.

Observation:

Prior to SRL treatment, the patient exhibited normal growth velocity (5.5 cm/year) and was at the 33.9th height percentile.
Following SRL initiation, growth velocity decreased to 2.2 cm/year, resulting in a decline to the 6th height percentile over two years.
Renal function remained optimal (CCr 68 ml/min per 1.73 m(2)) throughout the observation period.

Findings:

Sirolimus treatment was associated with a marked reduction in linear growth velocity in a pediatric renal transplant recipient.
The anti-proliferative and anti-angiogenic properties of sirolimus are potential mechanisms for impaired growth.
Human recombinant growth hormone was required to achieve catch-up growth, reaching the 49th height percentile.

Implications:

Pediatric transplant recipients receiving sirolimus require vigilant monitoring of linear growth.
The potential for sirolimus to negatively impact growth in children necessitates careful consideration of its use.
Further research into the long-term effects of sirolimus on pediatric growth and development is warranted.