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Tacrolimus related neurologic complication after pediatric kidney transplantation

Woo-Hyung Kwun1

  • 1Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Journal of the Korean Surgical Society
|November 9, 2011
PubMed

Insights

Tacrolimus, a calcineurin inhibitor, may cause neurotoxicity. A kidney transplant patient experienced stroke-like symptoms, which resolved after discontinuing tacrolimus treatment, suggesting a causal link.

Area of Science:

  • Nephrology
  • Neurology
  • Immunology

Background:

  • Calcineurin inhibitors are crucial immunosuppressants following organ transplantation.
  • Neurotoxicity is an emerging concern with these potent immunosuppressive agents.
  • Tacrolimus is a widely used calcineurin inhibitor in kidney transplantation.

Observation:

  • An 11-year-old kidney transplant recipient developed sudden hypertension, headache, and left-sided motor weakness.
  • Brain imaging revealed acute cerebral infarction and multiple arterial stenoses in the right cerebral hemisphere.
  • Neurological symptoms appeared on post-operative day 12.

Findings:

  • Cessation of tacrolimus treatment led to significant clinical and radiological improvement.
  • The patient's neurological complications were strongly associated with tacrolimus administration.
  • Cerebral infarction and arterial stenosis are potential neurotoxic effects of tacrolimus.

Implications:

  • Clinicians should be vigilant for neurological complications in patients receiving tacrolimus.
  • Early recognition and discontinuation of tacrolimus may be critical for managing neurotoxicity.
  • Further research is warranted to elucidate the mechanisms of tacrolimus-induced neurotoxicity and optimize patient monitoring.

Keywords:
Neurotoxicity syndromesTacrolimus

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