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L. Zimski, J. Olson, N. Mandava; Immune Recovery Uveitis Associated with FK 506 (Tacrolimus) Use After Renal Transplantation . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3071.
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To report two cases of patients immunosuppressed with FK 506 (tacrolimus) after renal transplantation who developed CMV retinitis followed by immune recovery uveitis with immune reconstitution
Retrospective chart review. Main outcome measures were visual acuity, CMV retinitis activity, and optical coherence tomography measurements of macular edema.
Case 1: A 44–year–old woman with a history of reflux nephropathy status–post renal transplant 6 developed CMV retinitis while immune suppressed with tacrolimus. Reduction of the tacrolimus and oral valganciclovir lead to resolution of the retinitis. However, she subsequently developed immune recovery uveitis and diffuse macular edema. Case 2: A 40–year–old woman underwent a renal transplant 14 months earlier and was maintained on FK 506 and prednisone. She developed CMV retinitis and a gancyclovir implant was placed and the tacrolimus dosage reduced. The CMV retinitis resolved completely But six months later her visual acuity declined secondary to cystoid macular edema associated with immune recovery uveitis.
Immune recovery uveitis may occur with immune system reconstitution after tacrolimus immune suppression for renal transplantation.
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