Risk of diabetes mellitus increases after solid organ and hematopoietic stem cell transplantation. Diabetic ketoacidosis has been reported after solid organ transplantation in patients receiving tacrolimus but has rarely been reported after stem cell transplantation. The major risk factors for diabetic ketoacidosis are immunosuppressive drugs used after transplantation. We report here three cases of allogenic stem cell transplant who developed diabetic ketoacidosis while on treatment with tacrolimus. The drug was stopped in all the cases and patients were treated with insulin therapy resulting in complete recovery from diabetic ketoacidosis.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Fortune K, Couriel D (2009) Tacrolimus in hematopoietic stem cell transplantation. Expert Opin Drug Metab Toxicol 5(7):835–841
Koehler MT, Howrie D, Mirro J, Neudorf S et al (1995) FK506 (tacrolimus) in the treatment of steroid-resistant acute graft-versus-host disease in children undergoing bone marrow transplantation. Bone Marrow Transplant 15(6):895–899
Kramer BK, Montagnino G, Castillo D et al (2005) Efficacy and safety of tacrolimus compared with cyclosporin A microemulsion in renal transplantation: 2 year follow-up results. Nephrol Dial Transpl 20:968–973
Salvadori M, Bertoni E, Rosati A, Zanazzi M (2003) Post-transplant diabetes mellitus. J Nephrol 16(5):626–634
Greenspan LC, Gitelman SE, Leung MA et al (2002) Increased incidence in post-transplant diabetes mellitus in children: a case control analysis. Pediatr Nephrol 17:1–5
Traggiai C, Stanhope R, Nussey S, Leiper AD (2002) Diabetes mellitus after bone marrow transplantation during childhood. Med Pediatr Oncol 40:128–129
Griffith ML, Jagasia M, Jagasia SM (2010) Diabetes mellitus after hematopoietic stem cell transplantation. Endocr Pract 16(4):699–706
Solmaz S, Gökgöz Z, Gereklioğlu C et al (2017) Tacrolimus-induced diabetic ketoacidosis after allogeneic bone marrow transplant. Exp Clin Transpl 15(6):702–703
Ricordi C, Zeng Y, Alezandro R et al (1991) In vivo effect of FK506 on human pancreatic islets. Transplantation 52:519–522
Duijnhoven EM, Boots JM, Christiaans MH et al (2001) Influence of tacrolimus on glucose metabolism before and after renal transplantation: a prospective study. JASN 12:583–588
Jindal RM, Sidner RA, Milgrom ML (1997) Post-transplant diabetes mellitus. The role of immunosuppression. Drug Saf 16(4):242–257
Yoshida EM, Buczkowski AK, Sirrs SM, Elliott TG et al (2000) Post-transplant diabetic ketoacidosis—a possible consequence of immunosuppression with calcineurin inhibiting agents: a case series. Transpl Int 13:69–72
Montori VM, Basu A, Erwin PJ et al (2002) Posttransplantation diabetes: a systematic review of the literature. Diabetes Care 25(3):583–592
Naranjo CA, Busto U, Sellers EM et al (1981) A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 30:239–245
We are thankful to Ms Bharti for collecting the data.
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Sharma, S.K., Doval, D., Khandelwal, V. et al. Tacrolimus Induced Diabetic Ketoacidosis Following Hematopoietic Stem Cell Transplantation. Indian J Hematol Blood Transfus 35, 711–713 (2019). https://doi.org/10.1007/s12288-019-01113-w
- Stem cell transplant
- Diabetic ketoacidosis