A quick look at Pub Med for "tacrolimus" and "sickle" gives one hit: UI
10754131 - the patient had sickle cell disease
Stuttering priapism in a liver transplant patient with toxic levels
of fk506.
Urology. 1999 Aug;54(2):366.
PMID: 10754131 [PubMed - indexed for MEDLINE]
Coincidentally, whilst reading Dr Trull's mailing, one of our pharmacists
rang about something esle, so I asked him about this question. He had no
specific knowledge about FK506 and sickle cell disease but felt that it has
similar lipophilic propoerties to cyclosporin and should be handled in a
similar way by sickle cells.
Gareth
> -----Original Message-----
> From: Dr A.K. Trull [SMTP:[log in to unmask]]
> Sent: 02 May 2002 14:38
> To: [log in to unmask]
> Subject: Re: Tacrolimus Levels in Sickle Cell Anaemia
>
> An interesting observation. Blood haematocrit is one factor that can
> certainly influence the clearance of low-to-intermediate extraction,
> lipophilic drugs like tacrolimus. The low tacrolimus levels would be
> compatible with the increase in hepatic clearance that might be
> anticipated from poor erythrocyte uptake. Does the sickle cell
> itself have a lower capacity for tacrolimus than a rotund
> erythrocyte - sorry, don't know but it would be an easily testable
> question.
>
> Andrew Trull, PhD
> Clinical Scientist Grade C
> Head of Clinical Pharmacology
> Department of Pathology
> Papworth Hospital
> Papworth Everard
> Cambridge CB3 8RE
>
> Tel.: 01480-830541 (x4301)
> FAX: 01480-364777
>
> On Thu, 2 May 2002, Ian Godber wrote:
>
> > Dear all,
> >
> > Any ideas on the following would be much appreciated. We've got a 37
> year old male renal transplant patient who has sickle cell anaemia.
> Because of this, he is having weekly red cell exchange transfusions (~4
> units). He's on Tacrolimus (5 mg, twice a day) and we are currently
> monitoring this on samples taken prior to transfusion. These however are
> giving results consistently between 3-4 ug/L. Is anyone aware of poor
> uptake of Tacro by erythrocytes in patients with sickle cell, thus
> affecting whole blood concentrations? Also I would presume that his weekly
> transfusions will be affecting the concentrations but to what degree? His
> renal function appears to be fine, with creatinine concs of 110-120 umol/L
> >
> > Thanks in advance
> > Ian
> >
> > Dr Ian Godber
> > Clinical Chemistry
> > Nottingham City Hospital
> > http://www.ncht.org.uk/clinchem
> > http://www.acb.org.uk
> >
> >
>
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