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Immunosuppression-induced leukoencephalopathy from tacrolimus (FK506)
S L Small1, M B Fukui, G T Bramblett
1Department of Neurology, University of Pittsburgh, PA 15261-2003 , USA.
Annals of Neurology
|October 1, 1996
Summary
Tacrolimus (FK506) can cause neurotoxicity, specifically leukoencephalopathy in transplant patients. Reducing the tacrolimus dose resolves this demyelinating syndrome.
Area of Science:
- Neuroscience
- Immunology
- Transplantation Medicine
Background:
- Tacrolimus (FK506) is a crucial immunosuppressant for organ transplant recipients.
- Neurotoxic side effects, including leukoencephalopathy, are associated with tacrolimus use.
Observation:
- Three cases of tacrolimus-related leukoencephalopathy are presented.
- The condition involves demyelination, particularly in the parieto-occipital region and centrum semiovale.
- This neurological syndrome is observed in organ transplant patients.
Findings:
- Tacrolimus-related leukoencephalopathy is an uncommon neurological syndrome.
- The syndrome is not strictly correlated with specific serum tacrolimus levels.
- Demyelination is the key pathological feature.
Implications:
- Decreasing tacrolimus dosage leads to spontaneous resolution of the syndrome.
- Tacrolimus-induced leukoencephalopathy shares radiographic and pathological similarities with cyclosporine-induced leukoencephalopathy.
- Awareness of this neurotoxicity is vital for managing transplant patients on tacrolimus.