Patients with chronic renal failure often develop musculoskeletal problems such as renal osteodystrophy and amyloid arthropathy,1 and in successful renal transplantation other complications may ensue, particularly avascular necrosis.2 Since the availability of immunosuppressive agents for rejection, there has been a decrease in musculoskeletal problems, however, new complications have been described such as a symmetrical bone pain syndrome and reflex sympathetic dystrophy syndrome (RSDS), some of them related to cyclosporin.3-6

Tacrolimus is a novel macrolide with potent immunosuppressive effects and with a very similar mechanism of action to cyclosporine A—that is, calcineurin phosphatase inhibition.7 ,8 We report on a patient treated with tacrolimus, who developed a leg bone pain syndrome, two months after kidney transplantation.

The patient was a 50 year old woman with severe hypertension, treated with atenolol (100 mg/day), verapamil (240 mg/day) …