Colitis tacrolimus

Similar cases have been reported to the manufacturers. A possible relation between the macrolide molecular structure of tacrolimus and the development of C. difficile colitis remains to be established. 

Clinical experiences in the treatment of Crohn s disease and ulcerative colitis with tacrolimus have been reported by both European and American investigators. They have shown that tacrolimus was effective in both ulcerative colitis and Crohn s disease, especially severe cases that were resistant to conventional therapies [76-78]. Clinical studies in several other autoimmune diseases including systemic lupus erythematosus, multiple sclerosis, and myasthenia gravis are currently under way in the United States, Japan, and Europe. 

Infection risk Fatal Pneumocystis jirovecii pneumonia complicated immunosuppressive therapy in two patients with steroid-refractory ulcerative colitis taking steroids and tacrolimus [146" ]. Despite immediate therapy with high-dose co-trimoxazole and broad-spectrum antibiotics, both patients died with progressive respiratory failure. 

Kumatowska I, Banasiak M, Daniel P, Wagrowska-Danilewicz M, Nowicki M. Two cases of severe de novo colitis in kidney transplant recipients after conversion to prolonged-release tacrolimus. Transpl Int 2010 23(5) 553-8. 

Escher M, Stange EF, Herrlinger KR. Two cases of fatal Pneumocystis jirovecii pneumonia as a complication of tacrolimus therapy in ulcerative colitis—a need for prophylaxis. J Crohns Colitis 2010 4(5) 606-9. 

Gastrointestinal Severe new-onset colitis occurred in two kidney transplant recipients shortly after the introduction of a mod-ified-release formulation of tacrolimus instead of standard twice-daily tacrolimus in one case and ciclosporin in the other [85 ]. Both developed severe, intermittent bloody diarrhea, with abdominal pain, weight loss, dehydration, and worsening graft function. The symptoms did not abate after dosage reduction or withdrawal of mycophenolate. 

Schmidt KJ, HerrHnger KR, Emmrich J, Barthel D, Koc H, Lehnert H, et al. Short-term efficacy of tacrolimus in steroid-refractory ulcerative colitis - experience in 130 patients. Aliment Pharmacol Ther January 2013 37(l) 129-36. PubMed PMID 23121200. Epub 2012/11 /06. eng. 

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