Tacrolimus-Induced Post-Transplant Diabetes Mellitus: A Case Report

Abstract

A 38-year-old man presents to hospital in diabetic ketoacidosis (DKA) after developing presumed posttransplant diabetes mellitus (PTDM) following an orthotopic heart transplant due to fulminant viral myocarditis. Amongst his immunosuppressant therapy he took tacrolimus, which is commonly used after solid organ transplantation. Whilst it is very effective in preventing rejection, it has a range of side effects including an increased risk of PTDM. Depending on the organ transplanted, PTDM can affect between 10 to 40% of solid organ transplants and patients taking tacrolimus have been shown to be more likely to develop this side effect (Chowdhury, 2019). During his admission with myocarditis, he also developed Covid-19, which has been anecdotally associated with the development of new-onset diabetes and increased presentations of DKA.