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

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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.

Keywords: Tacrolimus, Acute cerebral infarction, Kidney transplantation

REFERENCES

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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.

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