Calcineurin-Inhibitor Induced Pain Syndrome in a Heart Transplant Patient

Transplant Proc. 2021 Oct;53(8):2630-2635. doi: 10.1016/j.transproceed.2021.08.014. Epub 2021 Sep 2.

Abstract

Calcineurin-inhibitor induced pain syndrome (CIPS) also called the "symmetrical bone syndrome" is a condition describing reversible lower extremity pain in patients after organ transplantation who are receiving calcineurin inhibitors, especially tacrolimus. We present a case of CIPS after orthotopic heart transplant complicated with concurrent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We emphasize the presentation; diagnostic evaluation, and findings. We then discuss the proposed pathophysiologic mechanisms of CIPS and conclude with discussion of management strategies. Additionally, we present a table to guide clinicians in assessing posttransplant bone pain syndromes. To our knowledge, this is the first article to describe a case of CIPS with concurrent SARS-CoV-2 infection.

Publication types

  • Case Reports

MeSH terms

  • COVID-19* / complications
  • Calcineurin
  • Calcineurin Inhibitors* / adverse effects
  • Heart Transplantation*
  • Humans
  • Pain / chemically induced*

Substances

  • Calcineurin Inhibitors
  • Calcineurin