{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:16:50Z","timestamp":1761513410779},"reference-count":6,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2014,3,14]],"date-time":"2014-03-14T00:00:00Z","timestamp":1394755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A patient with known steroid\u2010dependent rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) developed an acute symmetrical polyarthropathy of small and medium\u2010sized joints associated with markedly elevated inflammatory markers suggestive of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> flare, on day 4 after deceased\u2010donor renal transplantation. The patient received standard induction immunosuppression with methylprednisolone and basiliximab, and had commenced prednisolone, tacrolimus and mycophenolate mofetil. Serological investigations and joint aspirate to exclude infective causes and crystal arthropathy were unremarkable. High\u2010dose prednisolone (50\u2009mg daily) resulted in partial but unsustained symptomatic improvement. On suspicion of a medication\u2010related adverse event, tacrolimus and mycophenolate mofetil were changed to cyclosporine A and azathioprine on day 16. This was followed by rapid improvement in symptoms and normalization of inflammatory markers. Unexpected sequelae in the early post\u2010transplantation period create diagnostic and management challenges. Medication\u2010related adverse events are not uncommon, and we speculate in this case on the potential for medication\u2010induced immune system dysregulation stimulating disease activity in a chronic autoimmune condition after introduction of new immunosuppressants.<\/jats:p>","DOI":"10.1111\/nep.12190","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T12:12:40Z","timestamp":1390824760000},"page":"2-5","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute polyarthritis immediately after kidney transplantation: A medication\u2010induced rheumatoid arthritis flare?"],"prefix":"10.1111","volume":"19","author":[{"given":"Catherine","family":"Brumby","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Box Hill Hospital Eastern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Box Hill Hospital Eastern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Box Hill Hospital Eastern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"McMahon","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Box Hill Hospital Eastern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,14]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2001.tb00004.x"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01251.x"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(99)80095-X"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-011-1984-x"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2011.08.015"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02377.x"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12190","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T15:19:49Z","timestamp":1694445589000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,14]]},"references-count":6,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1111\/nep.12190"],"URL":"https:\/\/doi.org\/10.1111\/nep.12190","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,14]]},"assertion":[{"value":"2013-12-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-03-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}