Calcineurin Inhibitor Induced Multiple Infarctions

Hae-Bong Jeong; Jeong-Min Kim; Il-Han Yu; Jae-Han Bae; Oh-Sang Kwon; Kwang-Yeol Park

doi:10.4285/jkstn.2016.30.4.190

Journal List > J Korean Soc Transplant > v.30(4) > 1034498

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jeong, Kim, Yu, Bae, Kwon, and Park: Calcineurin Inhibitor Induced Multiple Infarctions

Case Report

J Korean Soc Transplant 2016;30(4):190-193.

Published online: 31 December 2016

DOI: https://doi.org/10.4285/jkstn.2016.30.4.190

Calcineurin Inhibitor Induced Multiple Infarctions

Hae-Bong Jeong, Jeong-Min Kim, Il-Han Yu, Jae-Han Bae, Oh-Sang Kwon, Kwang-Yeol Park

Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

Corresponding author: Jeong-Min Kim Department of Neurology, Chung-Ang University Hospital, Chung- Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea Tel: 82-2-6299-3126, Fax: 82-2-6299-1504 E-mail: bellokim1@gmail.com

Received 18 October 2016 Revised 6 December 2016 Accepted 8 December 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tacrolimus is the most commonly used immunosuppressant after kidney transplantation. Here, we report a patient with multiple cerebral infarctions during tacrolimus treatment after kidney transplantation. A 54-year-old female was admitted due to sudden onset right leg weakness. Brain magnetic resonance imaging (MRI) showed multiple acute infarctions but normal vasculature. Evaluations of cardiac embolism were unremarkable. After 8 months, her weakness progressed and follow-up brain MRI showed additional multiple infarctions. We changed here medication from tacrolimus to mycophenolate mofetil, and her symptoms improved gradually.

Go to :

Keywords: Tacrolimus, Acute cerebral infarction, Kidney transplantation

Fig. 1.

Initial magnetic resonance imaging (MRI) including (A) diffusion-weighted sequence and (B) susceptibility-weighted sequence shows multiple infarctions involving bilateral corona radiata. (C) Enhanced T1-weighted image and (D) intracranial angiography are normal. Follow-up MRI on re-admission shows (E) recurred acute infarctions involving brain stem and bilateral subcortical white matters from diffusion-weighted sequence and (F) increased white matter changes from fluid attenuated inversion recovery sequence.

REFERENCES

1. Kim Y, Lee SH, Lee DW, Jung H, Oh TS, Kim MJ, et al. Posterior reversible encephalopathy syndrome improved by changing immunosuppressant from calcineurin inhibitor to sirolimus in a kidney transplantation recipient. J Korean Soc Transplant. 2015; 29:166–9.

2. Wu Q, Marescaux C, Wolff V, Jeung MY, Kessler R, Lauer V, et al. Tacrolimus-associated posterior reversible encephalopathy syndrome after solid organ transplantation. Eur Neurol. 2010; 64:169–177.

3. Chegounchi M, Hanna MG, Neild GH. Progressive neurological disease induced by tacrolimus in a renal transplant recipient: case presentation. BMC Nephrol. 2006; 7:7.

4. Senzolo M, Ferronato C, Burra P. Neurologic complications after solid organ transplantation. Transpl Int. 2009; 22:269–278.

5. Kim MU, Kim SY, Son SM, Park YH. A case of tacrolimus-induced encephalopathy after kidney transplantation. Korean J Pediatr. 2011; 54:40–44.

6. Imataki O, Uemura M, Shintani T, Matsumoto K. Reversible cerebral vasoconstriction syndrome resulted in cerebral infarction after allogeneic stem cell transplantation: a case report. Ann Hematol. 2014; 93:895–896.

Go to :

TOOLS

Similar articles