Using Sirolimus for Posttransplant Management and Reduction of Tuberous Sclerosis Complex Progression in a Patient with End Stage Renal Disease Caused by Tuberous Sclerosis Complex

K. Lee, H. Kim, Sung-Han Yun, Jin Ho Lee, J. Oh, S. M. Kim, Y. Sin, Joong-Kyung Kim
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Abstract

Tuberous sclerosis complex (TSC) is a neurocutaneous disease ch aracterized by the formation of hamartomas in multiple organs. TSC can show lesions including facial angiofibroma, shagreen patch on the skin, cortical tuber, subependymal nodule, astrocytoma in the brain, cardiac rhabdomyoma, and renal angiomyolipoma. In particular, renal angiomyolipoma may be a cause of end-sta ge renal disease (ESRD). On the other hand, sirolimus has regulatory effects on cellular growth and proliferation via its inhibitory effect on a protein, mammalian target of rapamycin. We report o n a case of an 18-year-old male who underwent renal trans-plantation due to ESRD induced by TSC. Sirolimus played a role in successful treatment of TSC and effective immunosuppression for transplantation.Key Words: Tuberous sclerosis complex, Kidney transplantation, Sirolimus중심 단어: 결절성 경화증, 신장이식, 시로리무스
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使用西罗莫司治疗由结节性硬化症引起的终末期肾病患者的移植后管理和减少结节性硬化症进展
结节性硬化症(TSC)是一种以多器官错构瘤形成为特征的神经皮肤疾病。TSC可显示的病变包括面部血管纤维瘤、皮肤上的粗绿色斑块、皮质结节、室管膜下结节、脑星形细胞瘤、心脏横纹肌瘤和肾血管平滑肌脂肪瘤。特别是,肾血管平滑肌脂肪瘤可能是终末期肾病(ESRD)的一个原因。另一方面,西罗莫司通过抑制哺乳动物雷帕霉素靶蛋白对细胞生长和增殖具有调节作用。我们报告一例18岁男性因TSC引起的ESRD而行肾移植。西罗莫司在TSC的成功治疗和移植免疫抑制中发挥了重要作用。关键词:结节性硬化症;肾移植;西罗莫司
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