Reversible cerebral vasoconstriction syndrome triggered by tacrolimus mimicked neuropsychiatric involvement in systemic lupus erythematosus

Jun Inamo; Jun Kikuchi; Katsuya Suzuki; Yuko Kaneko; Hidekata Yasuoka; Hirokazu Fujiwara; Kunihiro Yamaoka; Tsutomu Takeuchi

doi:10.1080/24725625.2019.1617460

Reversible cerebral vasoconstriction syndrome triggered by tacrolimus mimicked neuropsychiatric involvement in systemic lupus erythematosus

Jun Inamo, Jun Kikuchi, Katsuya Suzuki, Yuko Kaneko, Hidekata Yasuoka, Hirokazu Fujiwara, Kunihiro Yamaoka, Tsutomu Takeuchi

Research output: Contribution to journal › Article › peer-review

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Abstract

A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) and treated with tacrolimus and prednisolone, developed severe headache suddenly. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) showed multiple constrictive lesions of right middle cerebral arteries and subarachnoid haemorrhage. The level of interleukin (IL)-6 in cerebrospinal fluid (CSF) was elevated to 301 pg/ml. Tacrolimus was discontinued, and then her symptoms started to improve on day 2. At day 6, MRI findings and IL-6 level in CSF also dramatically improved. Our case demonstrated that tacrolimus could trigger reversible cerebral vasoconstriction syndrome (RCVS) in SLE patients, even though the level of tacrolimus was kept in treatment level stably.

Original language	English
Pages (from-to)	119-123
Number of pages	5
Journal	Modern Rheumatology Case Reports
Volume	3
Issue number	2
DOIs	https://doi.org/10.1080/24725625.2019.1617460
Publication status	Published - 03-07-2019
Externally published	Yes

All Science Journal Classification (ASJC) codes

Rheumatology

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10.1080/24725625.2019.1617460

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title = "Reversible cerebral vasoconstriction syndrome triggered by tacrolimus mimicked neuropsychiatric involvement in systemic lupus erythematosus",

abstract = "A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) and treated with tacrolimus and prednisolone, developed severe headache suddenly. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) showed multiple constrictive lesions of right middle cerebral arteries and subarachnoid haemorrhage. The level of interleukin (IL)-6 in cerebrospinal fluid (CSF) was elevated to 301 pg/ml. Tacrolimus was discontinued, and then her symptoms started to improve on day 2. At day 6, MRI findings and IL-6 level in CSF also dramatically improved. Our case demonstrated that tacrolimus could trigger reversible cerebral vasoconstriction syndrome (RCVS) in SLE patients, even though the level of tacrolimus was kept in treatment level stably.",

author = "Jun Inamo and Jun Kikuchi and Katsuya Suzuki and Yuko Kaneko and Hidekata Yasuoka and Hirokazu Fujiwara and Kunihiro Yamaoka and Tsutomu Takeuchi",

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AU - Inamo, Jun

AU - Kikuchi, Jun

AU - Suzuki, Katsuya

AU - Kaneko, Yuko

AU - Yasuoka, Hidekata

AU - Fujiwara, Hirokazu

AU - Yamaoka, Kunihiro

AU - Takeuchi, Tsutomu

PY - 2019/7/3

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AB - A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) and treated with tacrolimus and prednisolone, developed severe headache suddenly. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) showed multiple constrictive lesions of right middle cerebral arteries and subarachnoid haemorrhage. The level of interleukin (IL)-6 in cerebrospinal fluid (CSF) was elevated to 301 pg/ml. Tacrolimus was discontinued, and then her symptoms started to improve on day 2. At day 6, MRI findings and IL-6 level in CSF also dramatically improved. Our case demonstrated that tacrolimus could trigger reversible cerebral vasoconstriction syndrome (RCVS) in SLE patients, even though the level of tacrolimus was kept in treatment level stably.

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Reversible cerebral vasoconstriction syndrome triggered by tacrolimus mimicked neuropsychiatric involvement in systemic lupus erythematosus

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