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NDT Advance Access originally published online on June 16, 2007
Nephrology Dialysis Transplantation 2007 22(9):2709-2712; doi:10.1093/ndt/gfm358
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reflex sympathetic dystrophy in a renal transplant patient treated with sirolimus

An Vanacker1, Ignace Vandewiele1, Patrik Aerts2, Jozef De Groof3 and Bart Maes1

1Department of Nephrology, 2Department of Radiology and 3Department of Nuclear Medicine, Heilig Hartziekenhuis Roeselare-Menen, B-8800 Roeselare, Belgium

Correspondence and offprint requests to: Bart Maes, MD, PhD, Heilig Hartziekenhuis Roeselare-Menen, Wilgenstraat 2, Roeselare 8800, Belgium. Email: bmaes@hhr.be

Keywords: renal transplantation; bone disease; reflex sympathetic dystrophy; algoneurodystrophy; sirolimus

The first 150 words of the full text of this article appear below.



   Introduction
 
Severe osteoarticular problems are common after solid organ transplantation. More specifically, unilateral foot pain can be induced by gout, fractures, avascular necrosis (due to corticosteroid treatment), foot deformities and exostosis. Bilateral foot pain after transplantation can be caused by polyneuropathy, osteoporosis and persistent hyperparathyroidism after transplantation. Recently, reflex sympathetic dystrophy as a rare complication of treatment with calcineurin-inhibitors has also been described as a cause of bilateral foot pain.



   Case
 
A 46-year-old male renal transplant patient presented with severe pain in the left tarsus in November 2005. The primary renal disease was chronic glomerulonephritis. The first two renal transplants failed (repetitive episodes of acute rejection in the first, persistent thrombotic microangiopathy related to calcineurin inhibitor intake in the second) and were removed. In August 2002, a third deceased donor kidney transplantation was performed, using corticosteroids (CS, methylprednisolone, Medrol®, David Bull Laboratories Pty Ltd, Mulgrave, Australia), mycophenolate mofetil (MMF, Cellcept®, Hoffmann-LaRoche, Basel, . . . [Full Text of this Article]



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