MICROANGIOPATHIC HEMOLYTIC-ANEMIA COMPLICATING FK506 (TACROLIMUS) THERAPY

We describe 3 episodes of microangiopathic hemolytic anemia (MAHA) in 2 solid organ recipients under FK506 (tacrolimus) therapy. In both cas es, discontinuation of FK506 and treatment with plasma exchange, fresh frozen plasma replacement, corticosteroids, aspirin, and dipyridamole led to resolution of MAHA. In one patient, reintroduction of FK506 le d to rapid recurrence of MAHA. FK5O6-associated MAHA is probably rare but physicians must be aware of this severe complication. In our exper ience and according to the literature, FK506 does not seem to cross-re act with cyclosporin A (CyA), an immunosuppressive drug already known to induce MAHA. (C) 1996 Wiley-Liss, Inc.