|
1
|
Anderson MA, Ying T, Wyburn K, Ferguson PM, Strach MC, Grimison P, Chadban S, Gracey DM. Transplant-associated penile Kaposi sarcoma managed with single agent paclitaxel chemotherapy: a case report. BMC Urol 2021; 21:87. [PMID: 34098936 PMCID: PMC8186205 DOI: 10.1186/s12894-021-00855-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
Background Kaposi’s sarcoma is an uncommon complication in renal transplant patients, and typically presents with cutaneous lesions on the lower extremities. Penile involvement has been reported only rarely. Management of cutaneous-limited disease is primarily reduction of immunosuppression and conversion to an mTOR-inhibitor, whereas the treatment of disseminated disease in transplant patients is more variable. Case presentation A 75-year-old male, originally from Somalia, received a deceased-donor kidney transplant for diabetic and hypertensive nephropathy. Seven months post-transplant he presented with lower limb lesions, oedema and bilateral deep vein thromboses. He then developed a fast-growing painful lesion on his penile shaft. A biopsy of this lesion confirmed KS, and a PET scan demonstrated disseminated disease in the lower extremities, penis and thoracic lymph nodes. His tacrolimus was converted to sirolimus, and his other immunosuppression was reduced. He was treated with single agent paclitaxel chemotherapy in view of his rapidly progressing, widespread disease. The penile lesion completely resolved, and the lower extremity lesions regressed significantly. His kidney allograft function remained stable throughout treatment. Conclusion This case illustrates a rare presentation of an uncommon post-transplant complication and highlights the need for a high index of suspicion of KS in transplant patients presenting with atypical cutaneous lesions. It serves to demonstrate that the use of single agent paclitaxel chemotherapy, switch to an mTORi and reduction in immunosuppression where possible produces excellent short-term outcomes, adding to the body of evidence for this management strategy in disseminated Kaposi’s sarcoma.
Collapse
Affiliation(s)
- Matthew A Anderson
- Department of Renal Medicine and Renal Transplant, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia.
| | - Tracey Ying
- Department of Renal Medicine and Renal Transplant, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia.,Kidney Node, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Kate Wyburn
- Department of Renal Medicine and Renal Transplant, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia.,Kidney Node, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Peter M Ferguson
- Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.,Department of Tissue Pathology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia
| | - Madeleine C Strach
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Peter Grimison
- Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.,Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Steve Chadban
- Department of Renal Medicine and Renal Transplant, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia.,Kidney Node, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - David M Gracey
- Department of Renal Medicine and Renal Transplant, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia.,Kidney Node, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
|
2
|
Glowacka P, Rudnicka L, Warszawik-Hendzel O, Sikora M, Goldust M, Gajda P, Stochmal A, Blicharz L, Rakowska A, Olszewska M. The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections. BIOLOGY 2020; 9:biology9080192. [PMID: 32731331 PMCID: PMC7463439 DOI: 10.3390/biology9080192] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.
Collapse
Affiliation(s)
- Paulina Glowacka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
- Correspondence:
| | - Olga Warszawik-Hendzel
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Mohamad Goldust
- Department of Dermatology, G. Marconi University of Rome, 00193 Rome, Italy;
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany
- Department of Dermatology, University Hospital Basel, 4031 Basel, Switzerland
| | - Patrycja Gajda
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Anna Stochmal
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Malgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| |
Collapse
|
|
3
|
Caposiena Caro RD, Coppola A, Didona D. Kaposi's sarcoma lung metastastis in transplanted patient treatment response with paclitaxel and everolimus. GIORN ITAL DERMAT V 2018; 155:232-234. [PMID: 30229635 DOI: 10.23736/s0392-0488.18.05904-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Angelo Coppola
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Dario Didona
- Division of Pulmunology, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| |
Collapse
|