Tacrolimus-induced polyneuropathy after heart transplantation

Area of Science:

• Neurology
• Immunology
• Transplantation Medicine

Background:

• Tacrolimus is a calcineurin inhibitor widely used to prevent organ rejection in transplant recipients.
• Neuropathy is a known potential adverse effect of tacrolimus, particularly in liver, pancreas, and renal transplant patients.

Observation:

• A 56-year-old female heart transplant recipient developed progressive symmetric sensorimotor polyneuropathy affecting the distal lower limbs.
• The neuropathy presented as a demyelinating process, impacting nerve function.

Findings:

• This is the first reported case of tacrolimus-induced demyelinating polyneuropathy in a heart transplant patient.
• The patient's neurological symptoms showed a rapid and complete reversal after discontinuation of tacrolimus therapy.

Implications:

• This case highlights the importance of considering tacrolimus-induced neuropathy in heart transplant recipients presenting with neurological deficits.
• Prompt recognition and drug withdrawal may lead to favorable neurological recovery.
• Further investigation into the mechanisms of tacrolimus neurotoxicity is warranted.