Severe tacrolimus leukoencephalopathy after liver transplantation

Tacrolimus is an immunosuppressive agent that can show a wide variety of neurologic side effects, including leukoencephalopathy. Although the prognosis is good-after cessation or dose reduction, complete recovery usually occurs-the differentiation with treatable diseases such as progressive multifocal encephalopathy can be difficult, making a stereotactic biopsy of the white matter lesion sometimes necessary. We describe the case of a 12-year-old girl with a severe, reversible tacrolimus-related leukoencephalopathy and only mild histopathologic abnormalities.