Acute left ventricular failure induced by cyclosporine and tacrolimus in a patient with dermatomyositis
10.3760/cma.j.cn114015-20190801-00628
- VernacularTitle:环孢素和他克莫司致皮肌炎患者急性左心衰竭
- Author:
Yunxing LIU
1
;
Qing SHU
;
Xian YANG
;
Yao YAO
;
Hong WANG
;
Cheng ZHAO
;
Weihong GE
Author Information
1. 南京大学医学院附属鼓楼医院药学部 210008；中国药科大学基础医学与临床药学学院，南京 210009
- Publication Type:Journal Article
- Keywords:
Heart failure;
Cyclosporine;
Tacrolimus
- From:
Adverse Drug Reactions Journal
2020;22(5):319-320
- CountryChina
- Language:Chinese
-
Abstract:
A 58-year-old female patient received cyclosporine 75 mg twice daily orally for dermatomyositis. Seven days later, the patient developed chest pain and dyspnea suddenly. Her oxygen saturation was 79% and the blood pressure was 190/125 mmHg. Laboratory tests showed her brain natriuretic peptide (BNP) 1 470.0 ng/L. The electrocardiogram showed a tall and sharp T-wave in the precordial lead. Chest X-ray showed enlarged heart shadow and suffused shadow in the right lung. The patient was diagnosed as acute left ventricular failure, which was considered to be related to cyclosporine. Cyclosporine was discontinued immediately. After the treatments with oxygen inhalation and IV infusions of methylprednisolone 80 mg and IV injection of furosemide 80 mg for 8 days, her symptoms improved and the BNP decreased to 318.0 ng/L. Then she received tacrolimus 2 mg twice daily orally for dermatomyositis. On day 2 of dermatomyositis treatment, she felt chest tightness and her BNP increased to 1 010.0 ng/L. Lefe ventricular failure induced by tacrolimus was considered. Tacrolimus was stopped immediately and the symptomatic treatments such as diuresis were given. On day 3 of dermatomyositis withdrawal, her chest tightness disappeared and the BNP decreased to 57.5 ng/L.
