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Example of the drug interaction between ciclosporin and orlistat, resulting in relapse of Evan's syndrome
  1. Irina Earnshaw,
  2. Jecko Thachil
  1. Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  1. Correspondence to Irina Earnshaw, irinaearnshaw{at}


A man aged 35 years with a history of Evan's syndrome presented to the clinic with jaundice and shortness of breath, with further testing indicating a relapse of his previously well-controlled condition, for which he was taking ciclosporin. This followed shortly after he had started taking orlistat to prevent weight gain from a course of steroids, and once the orlistat was stopped, his platelets began to rise. The patient required 4 months of steroid treatment before his platelet levels finally stabilised and he could be put back on his regular medicine regime.

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  • Contributors JT treated the patient and suggested that IE write the case report. IE did the literature review and wrote the report, and JT provided editing and comments.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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