环孢素致双上肢疼痛及AFU升高

The upper limb pain and elevated AFU caused by cyclosporine

1例22岁男性患者,因肾病综合征应用激素不敏感,给予环孢素每次150 mg,bid。用药1 h后,患者诉双上肢疼痛,且随时间推移进行性加重,未给予处理,24 h后疼痛缓解。用药5 d后,患者α-L-岩藻糖苷酶(AFU)364 U.L-1;第6天查甲胎蛋白(AFP)4.0 ng.mL-1,环孢素血药浓度194 ng.mL-1。调整环孢素剂量为每次100 mg,bid。第12天查AFU 330 U.L-1,AFP4.0 ng.mL-1,环孢素血药浓度121 ng.mL-1。CT未见明显异常。第28天查小便常规,蛋白消失。第38天患者出院。

One 22-year-old male patient with nephrotic syndrome received cyclosporine 150 mg twice a day for not sensitive to hormone therapy, One hour later, the patient complained of pain in both of upper limbs, and the pain got more severe as time went by. The pain was relieved without treatment after 24 hours. Five days later, the examination value of a-L-fucosidase （AFU） was 364 U.L-1. The examination value of alpha-fetoprotein （AFP） was 4.0 ng.mL-1, and the blood concentration of cyclosporine was 194 ng·mL-1 on the sixth day of cyclosporine treatment. And then, the dose of eyelosporine was adjusted to 100 mg twice a day. On the twelfth day, the results of AFU and AFP were 330 U·L1 and 4.0 ng.mLx, respectively, and the blood concentration of cyclosporine was 121 ng.mL-1. There was no abnormal finding by CT scan. Protein was not found by urine routine 28 days later. And the patient discharged after 38 days.