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Ciclosporin Gingival Hyperplasia — ESENeph MCQ

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EasyTransplantationCiclosporin Gingival HyperplasiaESENeph

A 45-year-old man with chronic kidney disease is on Ciclosporin for a kidney transplant. He develops gingival hyperplasia. What is the relationship?

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Correct answer: E — Gingival hyperplasia is a side effect of Ciclosporin, not Tacrolimus

Gingival hyperplasia is a well-known side effect of Ciclosporin (not Tacrolimus). It occurs in up to 25-30% of patients on Ciclosporin and is exacerbated by poor oral hygiene and concurrent calcium channel blocker use (Nifedipine also causes gingival hyperplasia). Management includes switching from Ciclosporin to Tacrolimus if possible, dental hygiene optimisation, and avoiding concomitant CCBs that worsen the condition. This is one reason Tacrolimus has largely replaced Ciclosporin in modern protocols.

Reference: KDIGO 2009 – Transplant Guideline; BNF – Ciclosporin ADRs