Tacrolimus-Associated Posterior Reversible Encephalopathy Syndrome in Renal Transplant Recipient in Early Posttransplant Period: Case Report

Exp Clin Transplant. 2024 Jan;22(Suppl 1):336-337. doi: 10.6002/ect.MESOT2023.P3.

Abstract

Posterior reversible encephalopathy syndrome is an emergency medical condition with varied causes presenting as reversible subcortical vasogenic brain edema caused by endothelial injury, resulting from changes in blood pressure or direct effects of cytokines on endothelium. Posterior reversible encephalopathy syndrome is manifested by neurologic symptoms. Common causes include hypertensive emergency, renal disease, preeclampsia, eclampsia, and immunosuppressive drugs. In this case report, a 17-year-old female patient on hemodialysis as a result of lupus nephritis who had previously undergone deceased donor organ transplant and was on triple immunosuppression presented with neurological symptoms of posterior reversible encephalopathy syndrome in the early posttransplant period. She was normotensive, and tacrolimus level was in desired level. She improved after cessation of tacrolimus from immunosuppression with complete resolution of radiological lesions. Posterior reversible encephalopathy syndrome can occur in solid-organ transplant recipients who are on tacrolimus as a part of immunosuppression.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation* / adverse effects
  • Lupus Nephritis* / complications
  • Lupus Nephritis* / diagnosis
  • Lupus Nephritis* / drug therapy
  • Posterior Leukoencephalopathy Syndrome* / chemically induced
  • Posterior Leukoencephalopathy Syndrome* / diagnosis
  • Pregnancy
  • Tacrolimus / adverse effects

Substances

  • Tacrolimus
  • Immunosuppressive Agents