Reversible Calcineurin Inhibitor-associated Sensorimotor Polyneuropathy in a Lung Transplant Recipient: A Case Report

Area of Science:

• Nephrology
• Neurology
• Transplantation

Background:

• Calcineurin inhibitors (CNIs) are essential for preventing organ rejection post-transplant.
• Neurotoxicity is a known adverse effect of CNIs, manifesting as tremors, seizures, and headaches.
• Managing CNI-induced neurotoxicity is crucial for patient outcomes.

Observation:

• A bilateral lung transplant recipient developed severe motor and sensory neuron dysfunction.
• The neurological symptoms were strongly suspected to be related to CNI therapy.
• Patient presented with significant neurological impairment affecting daily life.

Findings:

• Discontinuation of Calcineurin Inhibitors (CNIs) led to the resolution of neurological symptoms.
• Switching immunosuppression to a mammalian Target of Rapamycin (mTOR)-inhibitor was effective.
• The patient's motor and sensory neuron function significantly improved after the medication change.

Implications:

• This case highlights the potential for severe neurotoxicity from CNIs in lung transplant recipients.
• Alternative immunosuppressive agents like mTOR-inhibitors may be viable options for patients experiencing CNI-related neurological side effects.
• Further research into CNI neurotoxicity and alternative immunosuppression strategies is warranted.