Two Cases of Calcineurin Inhibitor-Associated Reversible Posterior Leukoencephalopathy Syndrome in Renal Transplant Recipients

N. Akutsu, C. Iwashita, M. Maruyama, K. Ootsuki, Taihei Ito, K. Saigo, Takashi Kenmochi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Reversible posterior leukoencephalopathy syndrome (RPLS) is one of the important side effects of calcineurin inhibitors (CNIs). Magnetic resonance imaging (MRI) of the brain is useful for the diagnosis of RPLS, showing the edema primarily in the cortex and subcortical white matter of the posterior brain regions. Interruption of CNIs is essential for the treatment of patients with RPLS. Herein we have described 2 cases (1.7%) of RPLS induced by CNIs after kidney transplantation. The first case was a 56-year-old man with chronic renal failure due to diabetic nephropathy who received a living-related kidney transplantation in 2006. Initial immunosuppressive therapy consisted of cyclosporine, mycophenolate mofetil (MMF), prednisolone, and basiliximab. Four months after transplantation, he developed unconsciousness and paralysis. The second case was a 24-year-old woman with end-stage renal disease due to Alport syndrome who received an ABO-incompatible living-related kidney transplantation. Initial immunosuppressive therapy consisted of tacrolimus, MMF, prednisolone, and basiliximab. On postoperative day 3, she developed convulsions and unconsciousness. In both patients, RPLS was diagnosed with neurological symptoms and MRI findings at early stage of the disease, and they recovered rapidly from the disease by the interruption of CNIs. Our data demonstrated that early diagnosis and immediate interruption of CNIs were essential for the treatment of RPLS after kidney transplantation.

Original languageEnglish
Pages (from-to)2416-2418
Number of pages3
JournalTransplantation Proceedings
Volume40
Issue number7
DOIs
Publication statusPublished - 01-09-2008
Externally publishedYes

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Posterior Leukoencephalopathy Syndrome
Kidney
Kidney Transplantation
Mycophenolic Acid
Unconsciousness
Immunosuppressive Agents
Prednisolone
Chronic Kidney Failure
Magnetic Resonance Imaging
Hereditary Nephritis
Brain
Diabetic Nephropathies
Tacrolimus
Therapeutics
Paralysis
Cyclosporine
Calcineurin Inhibitors
Transplant Recipients
Early Diagnosis
Edema

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

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abstract = "Reversible posterior leukoencephalopathy syndrome (RPLS) is one of the important side effects of calcineurin inhibitors (CNIs). Magnetic resonance imaging (MRI) of the brain is useful for the diagnosis of RPLS, showing the edema primarily in the cortex and subcortical white matter of the posterior brain regions. Interruption of CNIs is essential for the treatment of patients with RPLS. Herein we have described 2 cases (1.7{\%}) of RPLS induced by CNIs after kidney transplantation. The first case was a 56-year-old man with chronic renal failure due to diabetic nephropathy who received a living-related kidney transplantation in 2006. Initial immunosuppressive therapy consisted of cyclosporine, mycophenolate mofetil (MMF), prednisolone, and basiliximab. Four months after transplantation, he developed unconsciousness and paralysis. The second case was a 24-year-old woman with end-stage renal disease due to Alport syndrome who received an ABO-incompatible living-related kidney transplantation. Initial immunosuppressive therapy consisted of tacrolimus, MMF, prednisolone, and basiliximab. On postoperative day 3, she developed convulsions and unconsciousness. In both patients, RPLS was diagnosed with neurological symptoms and MRI findings at early stage of the disease, and they recovered rapidly from the disease by the interruption of CNIs. Our data demonstrated that early diagnosis and immediate interruption of CNIs were essential for the treatment of RPLS after kidney transplantation.",
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Two Cases of Calcineurin Inhibitor-Associated Reversible Posterior Leukoencephalopathy Syndrome in Renal Transplant Recipients. / Akutsu, N.; Iwashita, C.; Maruyama, M.; Ootsuki, K.; Ito, Taihei; Saigo, K.; Kenmochi, Takashi.

In: Transplantation Proceedings, Vol. 40, No. 7, 01.09.2008, p. 2416-2418.

Research output: Contribution to journalArticle

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