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Pathological effects of cyclosporin A in clinical practice

  • Chapter
Cyclosporin

Abstract

In the first report on the efficacy of cyclosporin A (CsA) in clinical renal transplantation three side-effects were observed: hirsutism, hepatotoxicity and nephrotoxicity1. Two female patients were reported to have slight increase in facial and limb hair, all seven patients had elevated levels of serum bilirubin and alkaline phosphatase, and serum creatinine was elevated in all, with four having unexplained primary oligo-anuria. The authors stated that nephrotoxicity had made management of the patients very difficult — still true a decade later — and that they had probably persisted with too high a dose of CsA and were hampered by the inability to measure blood levels. Since then a list of other, less serious, adverse effects of CsA therapy have been reported2. In the succeeding paragraphs an attempt will be made to elucidate these complications of CsA with particular attention given to nephrotoxicity.

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References

  1. Calne, R. Y., White, D. J. G., Thiru, S., Evans, D. B., McMaster, P., Dunn, D. C., Craddock, G. N., Pentlow, B. D. and Rolles, K. (1978) Cyclosporin A in patients receiving renal allografts from cadaver donors. Lancet, 2, 1323–1327.

    PubMed  CAS  Google Scholar 

  2. Canadian Multicentre Transplant Study Group (1983) A randomised clinical trial of cyclosporin in cadaveric renal transplantation. N. Engl. J. Med., 309, 809–812.

    Google Scholar 

  3. Hall, B.M., Tiller, D. J., Duggin, G. G., Horvath, J. S., Farnsworth, A., May, J., Johnson, J. R. and Sheil, A. R. (1985) Post-transplant acute renal failure in cadaver renal recipients treated with cyclosporine. Kidney Int., 28, 178–186.

    PubMed  CAS  Google Scholar 

  4. Merion, R. M., White, D. J. G., Thiru, Sathia, Evans, D. B. and Calne, R. Y. (1984) Cyclosporins:five years experience in cadaveric renal transplantation. N. Engl. J. Med., 310, 148–154.

    PubMed  CAS  Google Scholar 

  5. Calne, R. Y. and Wood, A. J. (1985) Cyclosporine in cadaveric renal transplantation: 3-year follow up of a European multicentre trial. Lancet, 2, 549–552.

    PubMed  CAS  Google Scholar 

  6. The Canadian Transplant Study Group (1985) Examination of parameters influencing the benefit: detriment ratio of cyclosporine in renal transplantation. Am. J. Kidney Dis., 5, 328–332.

    Google Scholar 

  7. Morris, P. J., Chapman, J. R., Allen, R. D., Ting, A., Thompson, J. E., Dunnill, N. S. and Wood, R. F. M. (1987) Cyclosporinconversion versus conventional immunosuppression: long-term follow-up and histological evaluation. Lancet, 1, 586–591.

    PubMed  CAS  Google Scholar 

  8. Wheatley H. C., Datzman, M., Williams, J. W., Miles, D. E. and Hatch, F. E. (1987) Long-term effects of cyclosporine on renal function in liver transplant recipients. Transplantation, 43, 614–647.

    Google Scholar 

  9. Dische F. E., Neuberger, J., Keating, J., Parsons, V., Calne, R. Y. and Williams, R. (1988). Kidney pathology in liver allograft recipients after long-term treatment with cyclosporin A. Lab. Invest., 58, 395–402.

    PubMed  CAS  Google Scholar 

  10. Myers, B. D. (1986) Cyclosporine toxicity. Kidney Int., 30, 964–974.

    PubMed  CAS  Google Scholar 

  11. Myers, B. D., Ross, J., Newton, L., Luetscher, J. and Perlroth, M. (1984) Cyclosporine-associated chronic nephropathy. N. Engl. J. Med., 311, 699–705.

    PubMed  CAS  Google Scholar 

  12. Hesse, C. L., Sutherland, D. E. R., Mauer, S. M. and Najarian, J. S. (1985) Creatinine clearance and serum creatinine levels before and after pancreas transplantation in 11 patients. N. Engl. J. Med., 312, 48.

    Google Scholar 

  13. Palestine, A. G., Austin III, H. A., Barlow, J. E., Antonovyeh, T. T., Sabris, S. G., Preuss, H. G. and Nussenblatf, R. B. (1986) Renal histopathologic alterations in patients treated with cyclosporine for uveitis. N. Engl. J. Med., 314, 1293–1298.

    PubMed  CAS  Google Scholar 

  14. Miescher, P. A., Favre, H., Chatelanat, F. and Mihatsch, M. J. (1987) Combined steroid-cyclosporine treatment of chronic autoimmune disease: clinical results and assessment of nephrotoxicity by renal biopsy. Klin. Wochenschr., 65, 727–736.

    PubMed  CAS  Google Scholar 

  15. Thiru, S., Maher, E. R., Hamilton, D. V., Evans, D. B. and Calne, R. Y. (1983) Tubular changes in renal transplant recipients on cyclosporine. Trans. Proc., 15, 2846–2850.

    Google Scholar 

  16. Whiting, P. H., Thomson, A. W., Blair, J. T. and Simpson, J. G. (1982) Experimental cyclosporine nephrotoxicity. Br. J. Exp. Pathol., 63, 88–92.

    PubMed  CAS  Google Scholar 

  17. Kahan, B. D. (1986) Cyclosporin nephrotoxicity: pathogenesis, prophylaxis, therapy and prognosis. Am. J. Kidne Dis., 5, 323–331.

    Google Scholar 

  18. Baxter, C R., Duggin, G. G., Willis, N. S., Hall, B. M., Horvath, J. S. and Tiller, D. J. (1982) Cyclosporin A induced increases in renin storage and release. Res. Commun. Chem. Pathol. Pharmacol., 37, 305–309.

    PubMed  CAS  Google Scholar 

  19. Osman, E. A., Barrett, J. J., Bewick, M. and Parsons, V. (1984) Does cyclosporine affect renal blood vessels? Lancet 1, 1470.

    PubMed  CAS  Google Scholar 

  20. Humes, H. D., Jackson, N. M., O’Connor, R. P., Hunt, D. A. and White, M. P. (1935) Pathogenic mechanisms of nephrotoxicity: Insights into cyclosporine nephrotoxicity. Transplant. Proc., 17, 51–54.

    Google Scholar 

  21. Paller, M. S. and Murray, B. M. (1985) Renal dysfunction in animal models of cyclosporine toxicity. Transplant. Proc., 17 (Suppl. 1), 155–158.

    PubMed  CAS  Google Scholar 

  22. Sullivan, B. A., Hak, L. J. and Finn, W. F. (1985) Cyclosporine nephrotoxicity: studies in laboratory animals. Transplant. Proc., 17, 145–148.

    PubMed  CAS  Google Scholar 

  23. Paller, M. S., Murray, B. M. and Ferris, T. F. (1985) Decreased blood flow after cyclosporine infusion. Kidney Int., 27, 346–349.

    Google Scholar 

  24. Myers, M. D., Sibley, R., Newton, L., Tomlanon, S. J., Boshkos, C., Stinson, E., Leutscher, J. A., Wray, D. J., Krasny, D., Coplon, N. S. and Perlroth, M. G. (1988) The long-term course of cyclosporine-associated chronic nephropathy. Kidney Int., 33, 590–600.

    PubMed  CAS  Google Scholar 

  25. Siegl, H., Ryffel, B., Petric, R., Shoemaker, P. and Muller, A. (1983) Cyclosporine, the resin-angiotensin-aldosterone system and renal adverse reactions. Transplant. Proc., 15, 2719–2721.

    CAS  Google Scholar 

  26. Neild, G. R, Rocchi, G., Imberti, L., Fumagalli, F. and Brown, Z. (1983) Effect of cyclosporine on prostacyclin synthesis by vascular tissue in rabbits. Transplant. Proc., 15, 2398–400.

    CAS  Google Scholar 

  27. Neild, G. H., Ivory, K. and Williams, D. G. (1983) Glomerular thrombi and infarction in rabbits with serum sickness following cyclosporine therapy. Transplant. Proc., 15, 2782–2786.

    Google Scholar 

  28. Rossi, V., Breviaro, F., Ghezzi, P., Dejana, E. and Mantovani, A. (1985) Prostacyclin synthesis induced in vascular cells by interleukin 1. Science, 229, 174–176.

    PubMed  CAS  Google Scholar 

  29. Voss, B. L., Hamilton, K. K., Samara, E. N. S. and McKee, P. A. (1988) Cyclosporine suppression of endothelial prostacyclin generation. Transplantation, 45, 793–796.

    PubMed  CAS  Google Scholar 

  30. Heikki, H. and Edgington, T. S. (1983) Allogeneic induction of the human T cell instructed monocyte procoagulant response is rapid and is elicited by HLA-DR. J. Exp. Med., 158, 962–968.

    Google Scholar 

  31. Hamilton, D. V., Evans, D. B., Henderson, R. G., Thiru, S., Calne, R. Y. and White D. J. G. (1982) Long-term nephrotoxicity of cyclosporin A in transplantation. Dialysis Transplant., 11, 146–160.

    Google Scholar 

  32. Hamilton, D. V., Evans, D. B. and Thiru, S. (1982) Toxicity of Cyclosporin A in organ grafting. In White, D. J. G. (ed.), Cyclosporin A (Amsterdam: Elsevier), pp. 393–409.

    Google Scholar 

  33. Mihatsch, M. J., Thiel, G., Spichtin, H. P., Oberholzer, M., Brunner, F. P., Harder, F., Olivieri, V., Bremer, R., Ryffel, B., Stocklin, E., Torhorst, J., Gudat, F., Zollinger, H. U. and Loertscher, R. (1983) Morphological findings in kidney transplants after treatment with cyclosporine. Transplant. Proc., 15, 2821–2835.

    Google Scholar 

  34. Farnsworth, A., Hall, B. M., Bishop, G. A., Duggin, G. C., Goodman, B., Horvath, J., Johnson, J., Ng, A., Sheil, A. G. R. and Tiller, D. J. (1983) Pathology in renal transplant patients treated with cyclosporine A. Transplant Proc., 15, 2852–2854.

    Google Scholar 

  35. Sibley, R. K., Rynasiewicz, J., Ferguson, R. M., Fryd, D., Sutherland, D. E. R. (1983) Morphology of cyclosporine nephrotoxicity and acute rejection in patients immunosuppressed with cyclosporine and prednisolone. Science, 94, 225–234.

    CAS  Google Scholar 

  36. Farnsworth, A., Horvath, J., Hall, B. M, Sheil, A. G. R., Ng, A. B. P., Tiller, D. J. and Duggin, G. C. (1984) Am. J. Surg. Pathol. 8, 243–252.

    PubMed  CAS  Google Scholar 

  37. Mihatsch, M. J., Thiel, G., Ryffel, B. B., Von Overbeck, J. and Zollinger, H. U. (1985). Morhological patterns in cyclosporine-treated renal transplant recipients. Transplant. Proc., 17, 101–115.

    PubMed  CAS  Google Scholar 

  38. Klintmalm, G., Bohman, S.-O., Sundelin, B. and Wilczek, H. (1984) Interstitial fibrosis in renal allografts after 12–46 months of cyclosporin treatment. Beneficial effects of low doses in early post-transplant period. Lancet 2, 950–953.

    PubMed  CAS  Google Scholar 

  39. Bohman, S.-O., Klinfemalm, G., Ringdn, O., Sundelin, B. and Wilczek, H. (1985) Interstial fibrosis in human kidney grafts after 12 to 46 months of cyclosporine therapy. Transplant. Proc., 17, 1168–1171.

    Google Scholar 

  40. Bignardi, L., Neild, G. H., Hartley, R B., Taube, D. H., Cameron, J. S., Rudge, C. J., Williams, D. G. and Ogg, C. S. (1987) Histopathological changes in Cyclosporine treated renal allografts biopsied at I and 12 months. Nephrol. Dial. Transplant., 2, 366–370.

    PubMed  CAS  Google Scholar 

  41. d’Ardenne, A. J., Dunnill, M. S., Wood, R. F. M., Thompson, J. F. and Morris, P. J. (1985) Cyclosporine treatment does not cause specific histologic changes in human renal allografts. Transplant. Proc., 17, 1166–1167.

    Google Scholar 

  42. Morris, P. J., Alien, R. D., Thompson, J. F., Chapman, J. R., Ting, A., Dunnill, M. S. and Wood, R. F. M. (1987) Cyclosporin conversion versus conventional immunosuppression. Long term follow up and histological evaluation. Lancet, 1, 586–591.

    PubMed  CAS  Google Scholar 

  43. Merion, R. M., White, D. J. G. and Calne, R. Y. (1983) Early renal allograft rejection episodes are less aggressive with Cyclosporine A immunosuppression. Transplant. Proc., 15, 2172–2177.

    PubMed  CAS  Google Scholar 

  44. Flechner, S. M., Payne, W. D., Van Buren, C. T., Kerman, R. H. and Kahan, B. D. (1983) The effect of cyclosporine on early graft function in human renal transplantation. Transplantation, 36, 268–272.

    PubMed  CAS  Google Scholar 

  45. Bergstrand, A., Bohmann, S. O., Farnsworth, A., Gokel, J. M., Krause, P. H., Lang, W., Mihatsch, M. J., Oppedal, B., Sell, S., Sibley, R. K., Thiru, S., Verani, R., Wallace, A. C, Zollinger, H. U., Ryffel, B., Thiel, G. and Wonigeit, K. (1985) Renal histopathology in kidney transplant recipients immunosuppressed with cyclosporin A. Clin. Nephrol., 24, 107–119.

    Google Scholar 

  46. Thiru, S. and Calne, R Y. (1981) Giant mitochondria, renal transplant biopsy and cyclosporin A. Lancet, 2, 147.

    Google Scholar 

  47. Thomson, A. W., Whiting, P. H., Blair, J. T., Davidson, R. J. L., Simpson, J. G. (1981) Pathological changes developing in the rat during a 3 week course of high dosage cyciosorin A and their reversal following drug withdrawal. Transplantation, 32, 271–227.

    PubMed  CAS  Google Scholar 

  48. Shulman, J., Striker, G., Deeg, H. J., Kennedy, M., Storb, R. and Thoams, E. D. (1981) Nephrotoxicity of cyclosporine after allogeneic marrow transplantation. N Engl. J. Med., 305, 1392–1395.

    PubMed  CAS  Google Scholar 

  49. Neild, G. H., Reuben, R., Hartley, R. B. and Cameron, J. S. (1985) Glomerular thrombi in renal allografts associated with Cyclosporin treatment. J. Clin. Pathol., 38, 253–258.

    PubMed  CAS  Google Scholar 

  50. Neild, G. H., Taube, G. H., Hartley, R. B., Bignardi, L., Cameron, J. S., Williams, D. G., Ogg, C. S. and Rudge, C. J. (1986) Morphological differentiation between rejection and Cyclosporin nephrotoxicity in renal allografts. J. Clin. Pathol, 39, 152–159.

    PubMed  CAS  Google Scholar 

  51. Bonser, R. S., Adu, D., Franklin, I. and McMaster, P. (1984) Cyclosporin induced haemolytic syndrome in liver allograft recipients. Lancet, 2, 1337.

    PubMed  CAS  Google Scholar 

  52. Dzik, W. H., Georgi, B. A., Khettry, U. and Jenkins, R. L. (1987) Cyclosporine-associated thrombotic thrombocytopenic purpura following liver transplantation — successful treatment with plasma exchange. Transplantation, 44, 570–572.

    PubMed  CAS  Google Scholar 

  53. Leithner, C., Sinzinger, H., Pohanka, E., Schwarz, M. and Kretschmer, G., Syre, C. (1983) Occurrence of haemolytic uremic syndrome under cyclosporine treatment: accident or possible side effect mediated by a lack of prostacyclm-stimulating plasma factor? Transplant. Proc., 15, 2787–2789.

    Google Scholar 

  54. Morzuka, M., Croker, B. P., Seigler, H. F. and Tisher, C. C. (1982) Evaluation of recurrent glomerulonephritides in kidney allografts. Am. J. Med., 72, 588–598.

    Google Scholar 

  55. Hamilton, D. V., Calne, R. Y. and Evans, D. B. (1982) Haemolytic-uraemic syndrome and cyclosporin A. Lancet, 2, 151–152.

    PubMed  CAS  Google Scholar 

  56. Landmann, J., Mihatsch, M. J., Ratschek, M. and Thiel, G. (1987) Cyclosporine A and intravascular coagulation. Transplant. Proc., 19, 1817–1819.

    PubMed  CAS  Google Scholar 

  57. Porter, K. A., Rendal, J. M., Stolinslri, C., Terasaki, P. I., Marachioro, T. L. and Stand, T. E. (1966) Light and electronmicroscopic study of biopsies from 33 human renal allografts and an isograft 13/4—21/2 years after transplantation. Ann. N.Y. Acad. Sci., 19, 615–625.

    Google Scholar 

  58. Risdon, R. A., Sloper, J. C. and DeWardener, H. E. (1968) Relationship between renal function and histological changes found in renal biopsy specimens from patients’ with persistent glomerulonephritis. Lancet, 2, 363–365.

    PubMed  CAS  Google Scholar 

  59. MacKensen-Haen, S., Baden, R., Grund, K. E. and Bohle, A. (1981). Correlations between renal cortical interstitial fibrosis, atrophy of the proximal tubules and impairment of the glomerular filtration rate. Clin. Nephrol., 15, 167–171.

    PubMed  CAS  Google Scholar 

  60. Thurau, K. and Boylan, J. W. (1976) Acute renal success. The unexpected logic of oliguria in acute renal failure. Am. J. Med., 61, 308–315.

    PubMed  CAS  Google Scholar 

  61. Sommer, B. G., Henry, M. L. and Ferguson, R. M. (1986). Cyclosporine-associated renal arteriopathy. Transplant. Proc., 18, 151–154.

    PubMed  CAS  Google Scholar 

  62. Giroux, L., Smeesters, C., Gorman, J., Paquin, F., Allaire, G., St-Louis G. and Daloze, P. (1986) Hemolytic uremic syndrome in renal allografted patients treated with cyclosporin. Can. J. Physiol Pharmacol., 65, 1125–1131.

    Google Scholar 

  63. Wiles, P. G., Solomon, L. R., Lauler, W., Mallick, N. P. and Johnson, M. (1981) Inherited plasma factor deficiency in haemolytic-uraemic syndrome. Lancet, 1, 1105–1106.

    PubMed  Google Scholar 

  64. Adu, D., Turne, J., Michael, J. and McMaster, P. (1983) Hyperkalaemia in cyclosporin treated renal allograft recipients. Lancet, 2, 370–371.

    PubMed  CAS  Google Scholar 

  65. European Multicentre Trial Study Group (1983) Cadaveric renal transplantation: One year follow-up of a multicentre trial. Lancet, 2, 986–990.

    Google Scholar 

  66. Chapman, J. R., Marcer, R., Arias, M., Raine, A. E. G., Dunnill, M. S. and Morris, P. J. (1987) Hypertension after renal transplantation. Transplantation, 43, 860–864.

    PubMed  CAS  Google Scholar 

  67. Klintmalm, G. B. G., Iwatsuki, S. and Starzl, T. E. (1981) Cyclosporin A hepatotoxicity in 66 renal allograft recipients. Transplantation, 32, 488–491.

    PubMed  CAS  Google Scholar 

  68. Kahan, B. D., Wideman, C., Reid, M., Gibbons, S., Jarowenko, M., Flechner, S. and Van Buren, C. T. (1984) The value of serial serum trough cyclosporine levels in human renal transplantation. Transplant. Proc, 16, 1195–1199.

    PubMed  CAS  Google Scholar 

  69. Sutherland, D. E. R., Fryd, D. S., Strand, M H., Canafax, D. M., Ascher, N. L., Payne, W. D., Simmons, R. L. and Najarian, J. S. (1985) Results of the Minnesola randomized prospective trial of Cyclosporine versus azathioprine-antilymphocyte globulin for immunosuppression in renal allograft recipients. Am. J. Kidney Dis., 5, 318–22.

    PubMed  CAS  Google Scholar 

  70. Lorber, M. I., Van Buren, C. T., Flechner, S. M., Williams, C. and Kahan, B. D. (1987) Hepatobiliary and pancreatic complications of Cyclosporine therapy in 466 renal transplant recipients. Transplantation, 43, 35–40.

    PubMed  CAS  Google Scholar 

  71. Najarian, J. S., Fryd, D. S., Strand, M., Canafax, D. M., Ascher, N. L., Payne, W. D., Simmons, R. L. and Sutherland, D. E. R. (1985) A single institution, randomized, prospective trial of Cyclosporine versus azathioprine—ALG for immunosuppression in renal allograft recipients. Ann. Surg., 201, 142–157.

    PubMed  CAS  Google Scholar 

  72. Kahan, B. D., Van Buren, C. T., Fechner, S. M., Jarowenka, M., Yasumura, T., Rogers, A. J., Yoshimura, N., LeGrue, S., Drath, D. B. and Kerman, R. H. (1985) Clinical and experimental studies using cyclosporine in renal transplantation. Surgery, 97, 125–140.

    PubMed  CAS  Google Scholar 

  73. Titney, N. L., Milford, E. L., Araujo, J. L., Strom, T. B., Carpenter, C. B. and Kirkman, R. L. (1984) Experiences with cyclosporine and steroids in clinical renal transplantation. Ann. Surg., 200, 605–613.

    Google Scholar 

  74. Tolkoff-Rubin, N. E. and Rubin, R. H. (1986). The impact of cyclosporine therapy on the occurrence of infection in the renal transplant recipient. Transplant. Proc., 18, 168–73.

    PubMed  CAS  Google Scholar 

  75. Ho, M., Gui, X. E. and Atchison, R. W. (1983) The effects of cyclosporine on viruses. Transplant. Proc., 15, 2917–2919.

    Google Scholar 

  76. Dummer, J. S., Hardy, A., Poorsatfcar, A. and Ho, M. (1983). Early infections in kidney, heart and liver transplant recipients on cyclosporin. Transplantation, 36, 259–267.

    PubMed  CAS  Google Scholar 

  77. Calne, R. Y., Rolles, K., White, D. J. G., Thiru, S., Evans, D. B., McMaster, P., Dunn, D. B., Craddock, G. N., Henderson, R. G., Aziz, S. and Lewis, P. (1979) Cyclosporin A initially as the only immunosuppressant in 34 recipients of cadaveric organs: 32 kidneys, 2 pancreases and 2 livers. Lancet, 2, 1033–1036.

    PubMed  CAS  Google Scholar 

  78. Thiru, S., Calne, R. Y. and Nagington, J. (1981) Lymphoma in renal allograft patients treated with Cyclosporin A as one of the immunosuppressive agents. Transplant. Proc., 13, 359–363.

    PubMed  Google Scholar 

  79. Penn, I. (1937) Cancers following cyclosporine therapy. Transplantation, 43, 32–34.

    Google Scholar 

  80. Penn, I. and First, M. R. (1986) Development and incidence of cancer following cyclosporine therapy. Transplant. Proc., 18, 210–213.

    PubMed  CAS  Google Scholar 

  81. Powles, R. L., Clink, H. M, Spence, D., Morgenstern, G., Watson, J. G., Selby, P. J., Woods, M., Barrett, A., Jameson, B., Sloane, J., Lawler, S. D., Kay, H. E. M., Lawson, D., McElwain, T. J. and Alexander, P. (1980) Cyclosporin A to prevent GVHD in man after allogenic bone-marrow transplantation. Lancet, 1, 327–329.

    PubMed  Google Scholar 

  82. Reitz, B. A. and Bieber, C. P. (1982) Cancer after the use of cyclosporin A in animals. Cancer Surv., 1, 613–619.

    Google Scholar 

  83. O’Conor, G. T. (1970) Persistent immunologic stimulation as a factor in oncogenesis, with special reference to Burkitt’s tumour. Am. J. Med., 48, 279–285.

    Google Scholar 

  84. Editorial (1978) Malaria and immunology. Lancet, 2, 974–975.

    Google Scholar 

  85. Hanto, D. W., Frizzera, G., Kazimiera, J., Gajl-Peczalska and Simmons, R. L. (1985) Epstein-Barr virus, immunodeficiency and B cell lymphoproliferation. Transplantation, 39, 461–472.

    PubMed  CAS  Google Scholar 

  86. Bird, A. G., McLachlan, S. M. and Britton, S. (1981) Cyclosporin A promotes outgrowth in vitro of Epstein-Barr virus-induced B-cells lines. Nature, 289, 300–301.

    PubMed  CAS  Google Scholar 

  87. Clearly, M. L. and Sklar, J. (1984) Lymphoproliferative disorders in cardiac transplant recipients are multiclonal lymphomas. Lancet, 2, 489–491.

    Google Scholar 

  88. Butler, T. T., Kalkwarff, K. L. and Kaldahl, W.B. (1987) Drug-induced gingival hyperplasia: phenytoin, cyclosporine and nifedipine. J. Am. Drug. Assoc., 114, 56–60.

    CAS  Google Scholar 

  89. Wysocki, G. P. Gretzinger, H. A., Lacipacis, A., Ulan, R. A., Stiller, C. R. Fibrous hyperplasia of the gingiva: A side effect of cyclosporine A therapy. Oral Surg., 55, 274–278.

    Google Scholar 

  90. Qunibi, W. Y., Akhtar, M., Ginn, E. and Smith, P. (1988) Kaposis sarcoma in cyclosporine-induced gingival hyperplasia. Am. J. Kidney Dis., 11, 349–352.

    PubMed  CAS  Google Scholar 

  91. Harper, J. I., Kendra, J. R., Desai, S., Staughton, R. C. D., Barrett, A. J. and Hobbs, J. R. (1984) Dermatological aspects of the use of CsA for prophylaxis of graft versus host disease. Br. J. Dermatol., 10, 469–474.

    Google Scholar 

  92. Gebhart, W., Schmidt, J. B., Schemper, M., Spona, J., Kopsa, H. and Zazgornik, J. (1986). Cyclosporin-A-induced hair growth in human renal allograft recipients and alopecia areata. Arch. Dermatol. Res., 278, 238–240.

    PubMed  CAS  Google Scholar 

  93. Reznik, V. M., Lyons Jones, K., Durham, B. L. and Medoza, S. A. (1987) Changes in facial appearance during cyclosporin treatment. Lancet, 2, 1405–1406.

    Google Scholar 

  94. Kahan, B. D., Flechner, S. M., Lorber, M. I., Jensen Chris, Golden, D. and Van Buren, C. T. (1986) Complications of cyclosporin therapy. World J. Surg., 10, 348–360.

    PubMed  CAS  Google Scholar 

  95. Barrett, A. J., Kendra, J. R., Lucus, C. F., Joss, D. V., Joshi, R., Pendharkar, P. and Hugh-Jones, K. (1982) Cyclosporin A as prophylaxis against graft versus host disease in 36 patients. Br. Med. J., 285, 162–166.

    CAS  Google Scholar 

  96. Durrant, S., Chipping, P. M., Palmer, S. and Gordon-Smith, E. C. (1982) Cyclosporine A, methyl prednisolone and convulsions. Lancet, 2, 829–830.

    PubMed  CAS  Google Scholar 

  97. Gross, M. L. P., Pearson, R. M., Kennedy, J., Moorhead, J. F. and Sweny, P. (1982). Rejection encephalopathy. Lancet, 2, 1217.

    PubMed  CAS  Google Scholar 

  98. Lewis, G. P. and Mangham, B. A. (1979) Pharmacology of graft rejection. Trends Pharmacol. Sci., 1, 18–21.

    CAS  Google Scholar 

  99. Powles, R. L., Kay, H. E. M. and Clink, M. M. (1983) Mismatched family donors for bone marrow transplantation as treatment for acute leukaemia. Lancet, 1, 612–615.

    PubMed  CAS  Google Scholar 

  100. Powell-Jackson, P. R., Carmichael, F. J. L., Calne, R. Y. and William, R. (1984) Adult respiratory distress syndrome and convulsions associated with administration of cyclosporine in liver transplant recipients. Transplantation, 38, 341–343.

    PubMed  CAS  Google Scholar 

  101. Blaauw, A. A. M., Leunissen, K. M. L., Cheriex, E. C., Wolters, J., Kootstra, G. and Van Hooff, J. P. (1987) Disappearance of pulmonary leak syndrome when intravenous cyclosporine is replaced by oral cyclosporine. Transplantation, 40, 758–759.

    Google Scholar 

  102. Palestine, A. G., Nussenblatt, R. B. and Chan, C. C. (1984) Side effects of systemic Cyclosporine in patients not undergoing transplantation. Am. J. Med., 77, 652–656.

    PubMed  CAS  Google Scholar 

  103. Calne, R. Y., Roles, K., White, D. J. G., Thiru, S., Evans, D. B. E., Henderson, R., Hamilton, D. V., Boone, N., McMaster, P., Gibby, O. and Williams, R. (1981) Cyclosporin A in clinical organ grafting. Transplant. Proc., 13, 349–359.

    PubMed  CAS  Google Scholar 

  104. Nyberg, G., Sandberg, L., Rydberg, L., Gabel, H., Persson, H., Wedel, N., Ahlman, J. and Brunger, H. (1984) ABO-autoimmune haemolytic anaemia in a renal transplant patient treated with cyclosporine Transplantion, 37, 529–530.

    CAS  Google Scholar 

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Authors
  1. Sathia Thiru
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Editors and Affiliations

  1. Immunopathology Laboratory, Department of Pathology, University of Aberdeen, Foresterhill, Aberdeen, AB9 2ZD, Scotland

    Angus W. Thomson BSc(Hons), MSc, PhD, DSc, MRCPath, FIBiol (Reader in Immunology) (Reader in Immunology)

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© 1989 Kluwer Academic Publishers

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Thiru, S. (1989). Pathological effects of cyclosporin A in clinical practice. In: Thomson, A.W. (eds) Cyclosporin. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0859-8_15

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  • DOI: https://doi.org/10.1007/978-94-009-0859-8_15

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6874-1

  • Online ISBN: 978-94-009-0859-8

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