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KMID : 0361120150290030166
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Korean Journal of Transplantation
2015 Volume.29 No. 3 p.166 ~ p.169
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Posterior Reversible Encephalopathy Syndrome Improved by Changing Immunosuppressant from Calcineurin Inhibitor to Sirolimus in a Kidney Transplantation Recipient
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Kim Yun-Mi
Lee Si-Hyeong
Lee Dong-Woo
Jung Hee-Soo
Oh Tae-Seon
Kim Min-Ji
Kang Ju-Yeon
Kang Sun-Woo
Kim Yeong-Hoon
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Abstract
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Posterior reversible encephalopathy syndrome (PRES) is neurotoxicity characterized by brain imaging findings of reversible subcortical vasogenic edema. Clinical manifestations include seizure, altered mental status, focal neurologic deficit, and headache. Tacrolimus, a potent immunosuppressant, is related to increased risk of PRES in transplantation recipients. We report on a case of PRES in a 48-year-old female kidney transplantation recipient who received immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. On postoperative day 14, she complained of moderate to severe headache which did not respond to usual analgesics. Magnetic resonance imaging showed high signal intensity on T2-weighted images and fluid-attenuated inverse recovery imaging in both parieto-occipital areas. The condition was improved after changing immunosuppressant from tacrolimus to sirolimus.
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KEYWORD
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Posterior leukoencephalopathy syndrome, Calcineurin inhibitors, Sirolimus, Kidney transplantation
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