Tacrolimus-induced cholestatic hepatotoxicity after renal transplantation: a case report

J Med Case Rep. 2024 Feb 26;18(1):116. doi: 10.1186/s13256-024-04394-6.

Abstract

Background: In this manuscript, we report a case of tacrolimus-associated hepatotoxicity in a kidney transplant recipient.

Case presentation: In this case report, a 56 years old Arab male patient who received a kidney transplant presented with icterus, weakness, and lethargy two weeks after transplantation and tacrolimus initiation. In laboratory analysis hyperbilirubinemia and a rise in hepatic enzymes were observed. All possible causes of hepatotoxicity were examined. The panel for infectious causes was negative. Drug-induced liver injury was diagnosed. The patient's immunosuppressive regimen was changed to a cyclosporine-based regimen and after this change bilirubin and hepatic enzymes decreased and the patient was discharged without signs and symptoms of hepatitis.

Conclusion: It seems that the patient's hyperbilirubinemia was due to tacrolimus, and the patient's bilirubin decreased after stopping tacrolimus.

Keywords: Hepatotoxicity; Hyperbilirubinemia; Tacrolimus.

Publication types

  • Case Reports

MeSH terms

  • Bilirubin
  • Chemical and Drug Induced Liver Injury* / etiology
  • Cholestasis* / chemically induced
  • Cyclosporine / adverse effects
  • Humans
  • Hyperbilirubinemia
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Tacrolimus / adverse effects

Substances

  • Tacrolimus
  • Immunosuppressive Agents
  • Bilirubin
  • Cyclosporine