[Relations of gingival hypertrophy and blood levels of cyclosporin A in patients with renal transplants]. / Relazione tra ipertrofia gengivale e livelli ematici di ciclosporina A nei pazienti con trapianto renale.

ABSTRACT

Gingival overgrowth is defined as hyperplasia of gingival tissue due to local, systemic or drug-related causes. To see if the incidence and severity of this side-effect are related to cyclosporine A (CyA) dosage and/or blood levels BCyA), we analysed data from 24 renal transplanted outpatients, grouped as follows controls (C, n = 3) patients on immunosuppressive therapy other than CyA; group 1 (G1, n = 10) patients with BCyA steadily 300 ng/mL (RIA); group 2 (G2, n = 11) patients with BCyA steadily between 301 and 650 ng/mL. BCyA averaged 290 +/- 21 in G1 and 481 +/- 100 in G2 (p less than 0.001) mean cyclosporine A dosage (mg/kg/die) was not significantly different 4.1 +/- 1.4 in G1 and 4.97 +/- 2.4 in G2. However, six patients in G2 also received calcium antagonists known to increase CyA blood levels (diltiazem and nicardipine) for clinical purposes or deliberately to increase CyA bioavailability. Mean time from transplant was (in months) 19 +/- 11 in G1, 16 +/- 15 in G2 and 62 +/- 24 in C (G1 vs G2 NS; C vs G1 and 2 p less than 0.001). Mean GFR (mL/min) was 75 +/- 22 in C, 65 +/- 18 in G1 and 53 +/- 19 in G2 (NS). Dental hygiene, as assessed by scoring (0-3 absent, mild, moderate and severe) the bacterial plaque, was similar in all groups. Gingival overgrowth, was similarly scored (0-3) and was absent in C and in 20% of G1, mild in 40% of G1 and 33% of G2, moderate in 40% of G1 and 33% of G2 and severe in 0% of G1 and 33% of G2 (G1 vs G2 p less than 0.05). Our data suggest that the severity of gingival overgrowth in transplanted patients with similar oral hygiene is mainly related to CyA blood levels.