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Kidney biopsy findings in cyclosporine-treated patients with insulin-dependent diabetes mellitus

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Summary

Renal biopsy specimens of 40 patients with recent-onset insulin-dependent diabetes mellitus treated with cyclosporine (CSA) for 6–29 months were examined. Cyclosporine-associated chronic vascular interstitial toxicity of moderate intensity was found in 10 patients (25%). The most prominent lesions were interstitial fibrosis and tubular atrophy. Arteriolopathy was less pronounced and glomerular damage unremarkable.

A significant correlation exists between the extent of tubular atrophy and CSA trough whole blood levels.

These data indicate that the development of CSA-associated chronic nephropathy is dose-dependent.

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Abbreviations

CSA:

Cyclosporine

IDDM:

insulin-dependent diabetes mellitus

References

  1. Bougnères PF, Carel JC, Castano L, Boitard C, Gardin JP, Landais P, Hors J, Mihatsch MJ, Paillard M, Chaussain JL, Bach JF (1988) Factors associated with early remission of type 1 diabetes in children treated with cyclosporine. N Engl J Med 318:663–670

    PubMed  Google Scholar 

  2. Dougados M, Awada H, Amor B (1988) A double-blind, placebo controlled study in 52 patients. Ann Rheum Dis 47:127–133

    PubMed  Google Scholar 

  3. Feutren G (1988) Functional consequences and risk factors of chronic cyclosporine nephrotoxicity in type I diabetes trials. Transplant Proc [Suppl 4]:356–366

    Google Scholar 

  4. Feutren G, Papoz L, Assan R, Vialettes B, Karsenty G, Vexiau P, Du Rostu H, Rodier M, Sirmai J, Lallemand A, Bach JF (1986) Cyclosporin increases the rate and length of remissions in insulin-dependent diabetes of recent onset; results of a multicentre double-blind trial. Lancet II:119–123

    Article  Google Scholar 

  5. Feutren G, Querin S, Tron F, Noël LH, Chatenoud L, Lesavre PH, Bach JF (1986) The effects of cyclosporine in patients with systemic lupus. Transplant Proc 18:643–644

    Google Scholar 

  6. Van Graffenried B, Krupp P (1986) Side effects of cyclosporine (Sandimmun) in renal transplant recipients and in patients with autoimmune diseases. Transplant Proc 18:876–883

    Google Scholar 

  7. Van Joost Th, Heule F, Stolz E, Beukers R (1986) Shortterm use of cyclosporin A in severe psoriasis. Br J Dermatol 114:615–620

    PubMed  Google Scholar 

  8. Kahan BD (1986) Cyclosporine nephrotoxicity: pathogenesis, prophylaxis, therapy and prognosis. Am J Kidney Dis 5:323–331

    Google Scholar 

  9. Miescher PA, Favre H, Chatelanat F, Mihatsch MJ (1987) Combined steroid-cyclosporin treatment of chronic autoimmune diseases. Clinical results and assessment of nephrotoxicity by renal biopsies. Klin Wochenschr 65:727–736

    Article  PubMed  Google Scholar 

  10. Mihatsch MJ (1985) Renal histopathology in kidney transplant recipients immunosuppressed with cyclosporin A: results of an international workshop. Clin Nephrol 24:107–119

    PubMed  Google Scholar 

  11. Mihatsch MJ, Bach JF, Coovadia HM, Forre O (1988) Cyclosporin-associated nephropathy in patients with autoimmune diseases. Klin Wochenschr 66:43–47

    Article  PubMed  Google Scholar 

  12. Mihatsch MJ, Thiel G, Basler V, Ryffel B, Landmann J, von Overbeck J, Zollinger HU (1985) Morphologic patterns in cyclosporine-treated renal transplant recipients. Transplant Proc 17 [Suppl 1]:101–116

    PubMed  Google Scholar 

  13. Mihatsch MJ, Thiel G, Ryffel B (1986) Morphology of cyclosporine nephropathy. Prog Allergy 38:447–465

    PubMed  Google Scholar 

  14. Nussenblatt RB, Palestine AG, Chan CC, Mochizuki M, Yancey K (1985) Effectiveness of cyclosporin therapy for Behçet's disease. Arthritis Rheum 28:671–679

    PubMed  Google Scholar 

  15. Palestine AG, Austin HA, Balow JE, Antonovych TT, Sabnis SG, Preuss HG, Nussenblatt RB (1986) Renal histopathologic alterations in patients treated with cyclosporine for uveitis. N Engl J Med 314:1293–1298

    PubMed  Google Scholar 

  16. Stiller CR, Dupré J, Gent M, Jenner MR, Keown PA, Laupacis A, Martell R, Rodger NW, von Graffenried B, Wolfe BMJ (1984) Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset. Science 223:1362–1367

    PubMed  Google Scholar 

  17. Tejani A (1987) Cyclosporine treatment in patients with primary glomerular diseases. Int J Pediat Nephrol 8:1–3

    PubMed  Google Scholar 

  18. Tindall RSA, Rollins JA, Phillips JT, Greenlee RG, Wells L, Belendiuk G (1987) Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis. N Engl J Med 316:719–724

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Institut für Pathologie der Universität Basel, Switzerland

    M. J. Mihatsch

  2. Institut für Pathologie der Universität Hamburg, FRG

    U. Helmchen

  3. Laboratoires d'Anatomie Pathologie, Centre Hospitalier Regional Marseille, France

    P. Casanova

  4. Laboratoires d'Anatomie Pathologie, Hôpital Necker Enfants Malades Paris, France

    R. Habib

  5. Department of Pathology, Herlev Hospital, University of Copenhagen, Denmark

    S. Larsen

  6. Department of Pathology, Shaughnessy Hospital, Vancouver, Canada

    A. Magil

  7. Service d'immunologie Clinique, Hôpital Necker, Paris, France

    L. H. Noel

  8. Pathology Unit, Children's Hospital, University of Helsinki, Finland

    J. Rapola

  9. Institut für Pathologie der Universität Wien, Austria

    J. Ulrich

  10. Department of Pathology, University of London/Ontario, Canada

    A. C. Wallace

Authors
  1. M. J. Mihatsch
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  2. U. Helmchen
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  3. P. Casanova
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  4. R. Habib
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  5. S. Larsen
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  6. A. Magil
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  7. L. H. Noel
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  8. J. Rapola
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  9. J. Ulrich
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  10. A. C. Wallace
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Mihatsch, M.J., Helmchen, U., Casanova, P. et al. Kidney biopsy findings in cyclosporine-treated patients with insulin-dependent diabetes mellitus. Klin Wochenschr 69, 354–359 (1991). https://doi.org/10.1007/BF02115783

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  • DOI: https://doi.org/10.1007/BF02115783

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