کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3012023 1181783 2016 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Síndrome de encefalopatía posterior reversible secundaria a tacrolimus
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Síndrome de encefalopatía posterior reversible secundaria a tacrolimus
چکیده انگلیسی
Calcineurin inhibitors, cyclosporine and tacrolimus, have played a major role in preventing graft rejection and graft-versus-host disease in patients undergoing bone marrow and solid organ transplantation. However, tacrolimus has adverse effects related with neurotoxicity, being the posterior reversible encephalopathy syndrome the most severe consequence of this neurotoxicity. We report the case of a 30 year-old woman with 2-day history of severe frontal headache, náusea, emesis, hiporexia and epigastric pain, without fever. History of heart transplant 45 days ago, immunosuppressive therapy with tacrolimus and mycophenolatemofetil. Appropriate levels of tacrolimus (12.1 ng/ml), normal imaging and lab results were documented, excluding vascular and infectious causes as well as tacrolimus neurotoxicity. Nevertheless, due to the development of neuropsychiatric disorders and despite tacrolimus levels being < 5.5 ng/ml, a new brain MRI was performed showing a reversible posterior leukoencephalopathy syndrome. Tacrolimus was switched to everolimus achieving complete remission. This is the first reported case in which the imaging alterations associated with posterior reversible encephalopathy syndrome were developed in a patient undergoing heart transplantation with tacrolimus levels < 10 ng/ml. The report of this case will allow the treating physician groups to consider this diagnosis regardless oftacrolimus levels within therapeutic range, allowing therefore an early recognition and treatment, thus avoiding the development of complications and/or neurological sequels.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Revista Colombiana de Cardiología - Volume 23, Issue 1, January–February 2016, Pages 69.e1-69.e5
نویسندگان
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