Tacrolimus-Induced Acute Esophageal Necrosis
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Updated: Dec 5, 2025

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
Kaitlin Wanta1, Ayokunle T Abegunde1
1Division of Gastroenterology, Loyola University Medical Center, Maywood, IL.
Abstract:
Acute esophageal necrosis (AEN) has been rarely described and has poorly understood pathophysiology although it is thought to be related to mucosal defense barrier disruption. We report a case of AEN in a 71-year-old patient with clinical signs of gastric outlet obstruction along with anemia and sepsis in the setting of a recent kidney transplant. After failing standard supportive measures, tacrolimus was switched to cyclosporin with overall rapid improvement of AEN and concomitant duodenal ulcerations. This case underscores a possible rare adverse effect of a commonly used immunosuppressant agent that, to our knowledge, has not been specifically reported.
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