Tacrolimus-induced severe headache associated with diffuse leukoencephalopathy: Evidence for an immune-mediated pathogenesis.


Journal

Journal of neuroimmunology
ISSN: 1872-8421
Titre abrégé: J Neuroimmunol
Pays: Netherlands
ID NLM: 8109498

Informations de publication

Date de publication:
15 05 2019
Historique:
received: 28 11 2018
revised: 22 12 2018
accepted: 09 01 2019
pubmed: 3 3 2019
medline: 4 12 2019
entrez: 3 3 2019
Statut: ppublish

Résumé

Tacrolimus-induced encephalopathy presents with acute neurological symptoms such as headache, seizures, visual disturbances, hemiplegia, and altered mental status. A 60-year-old woman, presented to our clinic with a 4-month history of severe headache. She recently underwent kidney transplantation and was taking tacrolimus. MRI scan showed diffuse and symmetric alterations involving both supratentorial and infratentorial white matter. Cerebral spinal fluid assessment for infectious diseases were negative but elevated total protein level and oligoclonal bands positivity were reported. Treatment with steroid bolus, along with tacrolimus tapering, provided clinico-radiological improvement. This is the first case of tacrolimus-induced neurotoxicity strongly suggestive of an immune-mediated pathogenesis.

Identifiants

pubmed: 30825860
pii: S0165-5728(18)30542-3
doi: 10.1016/j.jneuroim.2019.01.006
pii:
doi:

Substances chimiques

Immunosuppressive Agents 0
Tacrolimus WM0HAQ4WNM

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

55-58

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Carmelo Luca Smeralda (CL)

Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy. Electronic address: carmelosmeralda@gmail.com.

Gian Luigi Gigli (GL)

Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy; DMIF, University of Udine, Udine 33100, Italy. Electronic address: gigli@uniud.it.

Alberto Vogrig (A)

Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy.

Alessandro Marini (A)

Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy.

Mariarosaria Valente (M)

Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy; Department of Medicine, University of Udine Medical School, Udine 33100, Italy. Electronic address: mariarosaria.valente@uniud.it.

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Classifications MeSH