Kaposi sarcoma coexisting with new onset diabetes mellitus in a 42-year old KIDNEY TRANSPLANT RECIPIENT: A CASE REPORT

Abstract

Renal allograft recipients develop several complications such as infections and neoplasms. New onset diabetes mellitus is a common transplant complication but rarely coexist with Kaposi sarcoma. Case report: We report the case of a 42-year-old banker who presented with polyuria, polydipsia, polyphagia, weight loss and dark spots in the lower limbs 8 months after he had received a live-related kidney transplant in India. He is not a known diabetic and had no family history of diabetes mellitus. His post-transplant immunosuppressive drugs included Myfortic® (mycophenolate), tacrolimus and prednisolone. At presentation he was wasted, dehydrated and afebrile, with multiple hyperpigmented nodules and plaques in both his lower limbs. Random blood glucose was 38mmol/l, had 2+ glucosuria and no ketones. Biopsy of skin lesions showed features of Kaposi sarcoma. A diagnosis of post-transplant diabetes mellitus and Kaposi sarcoma was made. His treatment included soluble insulin and antibiotics. Tacrolimus was changed to sirolimus and mycophenolate was reduced to 360mg twice daily.

Conclusion: Coexistence of diabetes mellitus and karposi sarcoma occurs rarely among kidney transplant recipients. Evaluation of transplant recipient who developed diabetes for malignancies such as karposi sarcoma will improve patient and graft survival.