Fatemeh Yaghoubi
1, Maliheh Yarmohamadi
2*1 Nephrology Research Center and Department of Nephrology Tehran University of Medical Sciences, Tehran, Iran
2 Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical sciences, Semnan, Iran
Abstract
Neurotoxicity due to CNI (calcineurin inhibitors; cyclosporine or tacrolimus) is common after
organ transplantation and associated with significant morbidity and mortality. Early identification
of drug induced neurotoxicity in transplanted patients is important. We report a 45 year-oldwoman
who had undergone kidney transplantation and after 24 hours while she suffered from
blurred vision and severe headache that did not respond to analgesic drugs. She was administered
tacrolimus, prednisone, mycophenolate and anti-thymocyte globulin. Neurologic examination
revealed subjective homonymous hemianopia without focal deficit. Other laboratory tests and
brain magnetic resonance imaging (MRI) were normal. There was not any evidence of infections,
metabolic and neoplastic diseases. Diagnosis of posterior reversible encephalopathy syndrome
(PRES) was made by clinical finding. Tacrolimus was withdrawn 2 days after administration
and replaced by cyclosporine. Clinical symptoms were resolved 4 days after discontinuation of
tacrolimus.
Implication for health policy/practice/research/medical education:
Tacrolimus induced neurotoxicity and its neurologic manifestation is an important issue and should be considered in organ
transplanted patients even for those who recently initiated the treatment.
Please cite this paper as: Yaghoubi F, Yarmohamadi M. Early tacrolimus administration induced encephalopathy in a renal
transplanted patient; a case report. J Nephropharmacol. 2017;6(2):117-118. DOI: 10.15171/npj.2017.16.