Tacrolimus-Related Posterior Reversible Encephalopathy Syndrome in a Postlung Transplant Patient: A Case Report

We present the case of a 58-year-old woman with fibrotic hypersensitivity pneumonitis, without significant comorbidities, who developed posterior reversible encephalopathy syndrome (PRES) 7 days after a bilateral lung transplant. Initial symptoms included hypertension, headache, nausea, vomiting, and cortical blindness. Although no seizures were observed, the electroencephalogram revealed occipital epileptic discharges. Brain magnetic resonance imaging confirmed the diagnosis of PRES, showing a typical pattern of vasogenic edema in the corticosubcortical occipital regions. Tacrolimus was discontinued, and antihypertensives and anticonvulsants were initiated, resulting in complete neurological recovery within 4 days. After 16 days without calcineurin inhibitor, cyclosporine was introduced with no recurrence of the neurological condition.