Multiple allergies in a child treated with FK 506 after liver transplantation

摘要

Introduction: Induction of multiple allergies secondary to immunosuppression is uncommon. We present a 3-year-old girl who developed severe food and drug allergies after the initiation of FK 506 therapy.Case report: A preterm infant (31 weeks of gestation) was diagnosed with biliary atresia at 2 months of age. A Kasai procedure failed and liver transplantation was performed at 10 months of age. Initial nutrition consisted of a preterm formula and human milk; later Heparon junior and a normal diet was well tolerated. Because of two episodes of acute rejection during cyclosporine therapy, she was switched to FK 506. Thereafter, she developed severe allergic reactions against drugs (several classes of antibiotics and anaesthetics) and food. Early and late allergic symptoms occurred including severe eczema, rashes, itching, high fever, diarrhoea and wheezing. Total IgE increased from 2.8IU/ml before transplantation to > 1100 IU/ml after FK 506 was introduced. She only tolerated an amino-acid-based formula (Neocate). Unfortunately, chronic rejection developed and the child is listed for retransplantation.