Tacrolimus Induced Leukoencephalopathy in Liver Transplant Recipient at Therapeutic Blood Levels
Journal Title: Indian Journal of Applied Radiology - Year 2018, Vol 4, Issue 1
Abstract
Among the various Central Nervous System (CNS) complications of liver transplantation, immunosuppressant induced neurotoxicity constitutes a rare but important proportion. Cyclosporine-A and tacrolimus are two of the main immunosuppressive agents that have revolutionized transplant medicine. Neurotoxicity due to these agents is the major cause of seizures and headache occurring in post liver transplant patients. The signal changes on Magnetic Resonance Imaging (MRI) typically resemble Posterior Reversible Encephalopathy Syndrome (PRES) but can have heterogeneous often challenging imaging features. Prompt diagnosis and dose reduction/replacement of the immunosuppressant can reverse the symptoms and lead to improved survival of liver transplant patients. We report one such rare case of leukoencephalopathy which showed atypical PRES like signal changes and aseptic meningitis on MRI at therapeutic blood levels.
Authors and Affiliations
Acharya UV
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