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Related Experiment Video

Updated: Jun 19, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Akinetic mutism induced by tacrolimus.

Fernando Sierra-Hidalgo¹, Antonio Martínez-Salio, Sara Moreno-García

¹Department of Neurology, 12 de Octubre University Hospital, Madrid, Spain. fsierra.hdoc@salud.madrid.org

Clinical Neuropharmacology

|October 13, 2009

Summary

Tacrolimus intoxication can exceptionally cause akinetic mutism, a rare neurological syndrome. Early recognition and drug withdrawal are crucial for patient recovery and preventing lasting brain damage.

Related Experiment Videos

Last Updated: Jun 19, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Area of Science:

Neurology
Pharmacology
Transplantation Medicine

Background:

Akinetic mutism is a rare syndrome of impaired voluntary movement and speech.
Cerebrovascular disease is a common cause, but drug toxicity is less frequent.
Tacrolimus neurotoxicity is an uncommon cause of akinetic mutism.

Observation:

A 66-year-old liver transplant patient developed acute akinetic mutism.
Symptoms included mutism, akinesia, and waxy rigidity.
High tacrolimus levels (20.8 ng/mL) were detected.

Findings:

The patient recovered fully after tacrolimus was replaced with cyclosporine and mycophenolate mofetil.
This case highlights akinetic mutism as an exceptional presentation of tacrolimus neurotoxicity.
Magnetic resonance imaging and blood tests showed no other acute abnormalities.

Implications:

Early identification of tacrolimus-induced akinetic mutism is vital.
Prompt drug withdrawal can prevent persistent neurological deficits.
This emphasizes the importance of monitoring drug toxicity in transplant patients.