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- Title
Bullous pemphigoid induced by m- TOR inhibitors in renal transplant recipients.
- Authors
Atzori, L.; Conti, B.; Zucca, M.; Pau, M.
- Abstract
Background Bullous pemphigoid ( BP) is an acquired autoimmune disease, with typical histology and immune pathological findings, which might be associated with drug therapy. The list of responsible drugs increases every year, but a current literature revision do not include the mammalian target of rapamycin ( mTOR) inhibitors. By converse, bullous pemghigoid cases have been described in renal transplant recipients and associated with the allogenic graft itself, causing a cross reaction against the skin, or unbalancing the immune response, through a chronic cell-mediated suppression, non-specifically favouring the autoantibody production. Object and results Two cases of BP occurred, respectively, 10 days to 2 months after the addition to their current regimen of everolimus in a 35-year-old woman and sirolimus in a 65-year-old man. The graft functionality was within normal range. General corticosteroids therapy resistance, immediate improvement after drug discontinuation (dechallenge) and relapse after re-exposure (rechallenge) were striking criteria supporting a causative role of the drugs, grouped in the mTOR inhibitors class. Conclusions The diagnosis of drug-induced events is crucial for early management, and particularly bullous eruptions affect patients' health and quality of life. Additional research is necessary to confirm the m- TOR inhibitors association, which exploit the possible mechanisms and eventually point out preventive measures.
- Subjects
BULLOUS pemphigoid; KIDNEY transplantation; MTOR protein; ADRENOCORTICAL hormones; HORMONE therapy; RAPAMYCIN
- Publication
Journal of the European Academy of Dermatology & Venereology, 2015, Vol 29, Issue 8, p1626
- ISSN
0926-9959
- Publication type
Article
- DOI
10.1111/jdv.12662