Catatonic episode after kidney transplantation

Area of Science:

• Nephrology
• Neuroscience
• Psychiatry

Background:

• Catatonia is an uncommon but serious neuropsychiatric condition.
• Increasing reports link catatonia to organ transplantation, with immunosuppressants a suspected cause.
• The etiology of catatonia in some transplant recipients remains unknown.

Observation:

• A 21-year-old female recipient developed catatonia post-kidney transplant.
• Immunosuppressant drug levels (tacrolimus) were therapeutic, not toxic.
• Infections, uremia, and transplant rejection were excluded as causes.

Findings:

• The patient's catatonia was idiopathic, not directly linked to known transplant complications or medication toxicity.
• A combination of electroconvulsive therapy (ECT) and olanzapine was administered.
• This treatment regimen resulted in significant improvement of catatonic symptoms.

Implications:

• This case expands the differential diagnosis of catatonia in organ transplant recipients.
• It suggests that even with normal drug levels and absence of rejection, catatonia can occur post-transplant.
• Highlights the efficacy of ECT and olanzapine in managing refractory post-transplant catatonia.