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Updated: Aug 10, 2026
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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
Tacrolimus induced subacute cerebellar ataxia
Joseph Kaleyias1, Eric Faerber, Sanjeev V Kothare
1Division of Pediatric Neurology, Department of Pediatrics, St Christopher's Hospital for Children, Erie Avenue at Front Street, Philadelphia, PA 19134, USA. kaleyias@hotmail.com
Summary
Tacrolimus can cause neurologic side effects. This case highlights a rare, isolated cerebellar lesion causing ataxia, which improved after stopping tacrolimus.
Area of Science:
- Neuroscience
- Immunology
- Pharmacology
Background:
- Tacrolimus, a macrolide immunosuppressant, is crucial in transplant medicine.
- Neurologic side effects, ranging from mild to severe, are known complications of tacrolimus therapy.
- Reversible posterior leukoencephalopathy syndrome (RPLS) is a recognized major neurologic adverse effect.
Observation:
- A patient receiving tacrolimus developed subacute cerebellar ataxia.
- The neurological presentation was characterized by an isolated lesion in the cerebellum.
- Notably, there was no evidence of supratentorial involvement.
Findings:
- The observed cerebellar lesion was attributed to tacrolimus treatment.
- Discontinuation of tacrolimus led to partial reversibility of the cerebellar ataxia.
- This represents a distinct neurological manifestation compared to typical RPLS.
Implications:
- This case expands the spectrum of known tacrolimus-induced neurological adverse events.
- Highlights the importance of considering tacrolimus toxicity in patients with unexplained cerebellar dysfunction.
- Suggests that early recognition and drug withdrawal may lead to partial recovery from specific tacrolimus-related cerebellar lesions.
