Resolution of diffuse skin and systemic Kaposi's sarcoma in a renal transplant recipient after introduction of everolimus: a case report.

Abstract

We present a case report of a patient with diffuse skin and systemic Kaposi's sarcoma (KS), 1 year after renal transplantation. A concomitant Pyrenochaeta romeroi granuloma of the right hallux was diagnosed and illustrated an important immunodysfunction in our patient. Four months after reduction in immunosuppression and switch to everolimus, a total regression of the KS was observed. Reduction in the immunosuppression and treatment with terbinafine cleared the P. romeroi infection, while lowering immunosuppression and changing the type of immunosuppressive therapy were important steps in the successful management of the KS. In recent years, evidence of the antitumor effects of everolimus is increasing: total regression of KS in combination with renal function preservation in renal graft recipients is possible with mammalian target of rapamycin (mTOR) inhibitor-based regimens. In addition, with increasing numbers of human immunodeficiency virus-positive transplant recipients, mTOR inhibitors may play a more crucial role in the management of KS.

• Authors: D Detroyer, K Deraedt, P Schöffski, E Hauben, K Lagrou, M Naesens, M L Delforge, D Kuypers
• Journal: Transplant infectious disease : an official journal of the Transplantation Society (Transpl Infect Dis) Vol. 17 Issue 2 Pg. 303-7 (Apr 2015) ISSN: 1399-3062 [Electronic] Denmark
• PMID: 25645490 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Immunosuppressive Agents
• Everolimus
• Mycophenolic Acid
• Tacrolimus

Topics

• Adult
• Dermatomycoses (etiology, immunology)
• Drug Substitution
• Everolimus (therapeutic use)
• Female
• Graft Rejection (prevention & control)
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kidney Transplantation
• Liver Neoplasms (etiology, immunology)
• Mycophenolic Acid (adverse effects, analogs & derivatives)
• Sarcoma, Kaposi (etiology, immunology)
• Skin Neoplasms (etiology, immunology)
• Tacrolimus (adverse effects)
• Treatment Outcome