Nephrology Dialysis Transplantation, Vol 12, Issue 12 2694-2697, Copyright © 1997 by Oxford University Press
E Gomez, M Sanchez-Nunez, J Sanchez, C Corte, S Aguado, C Portal, J Baltar and J Alarez-Grande
Background: Gingival hyperplasia is a known
complication of cyclosporin therapy. Although plaque control has been shown
to be of benefit, gingival surgery is occasionally necessary. The aim of
this study was to review the effect of a short-course therapy with
azithromycin in renal transplant patients with cyclosporin-induced gingival
hyperplasia. Methods: Thirty-eight patients received
500 mg/day of azithromycin for 3 consecutive days. The degree of gingival
hyperplasia was classified as: 0, no gingival overgrowth; 1, mild
overgrowth; 2, moderate overgrowth, and 3, severe overgrowth. Gingival
bleeding and evolution of gingival hyperplasia were determined at 0
(pretreatment), 7, 30, 90 and 180 days. Cyclosporin, serum creatinine and
ALT levels were simultaneously determined on the same days.
Results: Seven patients were excluded, leaving a total
of 31 included in the trial. Eleven had a score of 3, 17 a score of 2, and
3 a score of 1. The degree of gingival hyperplasia was unrelated to the
dose and levels of cyclosporin. Gingival hyperplasia improved in all
patients (P <0.001, Friedman test). The degree of improvement was
better when the degree of hyperplasia was lower. In 27 patients gingival
hyperplasia remained absent 6 months later, 3 patients required a second
course of treatment, and another required gingival surgery. Gingival
bleeding, present in 28 patients when diagnosed, disappeared in all cases
in 2.2±1.2 (1-7) days. No adverse effects were observed.
Cyclosporin, serum creatinine, and ALT levels were not affected by
treatment. Conclusion: Azithromycin improves
cyclosporin-associated gingival hyperplasia, especially when administered
early in the process. Key words: azithromycin;
cyclosporin; gingival hyperplasia; renal transplant
CLINICAL REPORT
Treatment of cyclosporin-induced gingival hyperplasia with azithromycin
Servicio de Nefrologia, Hospital Central de Asturias, C/ Celestino Villamil s/n, E-33006 Oviedo, Spain; Corresponding author
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