A case of tacrolimus-induced encephalopathy after kidney transplantation

Title
A case of tacrolimus-induced encephalopathy after kidney transplantation
Author(s)
박용훈손수민김세윤김염욱[김염욱]
Keywords
Tacrolimus; Encephalopathy; Kidney; Transplantation; Tractography; Child
Issue Date
201101
Publisher
대한소아과학회
Citation
Korean Journal of Pediatrics, v.54, no.1, pp.42 - 44
Abstract
We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT) showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) of white matter tract, visualization was possible.
URI
http://hdl.handle.net/YU.REPOSITORY/25710
ISSN
1738-1061
Appears in Collections:
의과대학 > 소아청소년과학교실 > Articles
의과대학 > 재활의학교실 > Articles
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