PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy.

Hdl Handle:
http://hdl.handle.net/10147/200776
Title:
PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy.
Authors:
Hodnett, P; Coyle, J; O'Regan, K; Maher, M M; Fanning, N
Affiliation:
Department of Radiology, Cork University Hospital and University College Cork, Cork, Ireland.
Citation:
PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy. 2009, 16 (6):493-6 Emerg Radiol
Journal:
Emergency radiology
Issue Date:
Nov-2009
URI:
http://hdl.handle.net/10147/200776
DOI:
10.1007/s10140-008-0782-6
PubMed ID:
19096887
Abstract:
With increasing numbers of solid organ and hematopoietic stem cell transplantations being performed, there have been significant increases in the use of immunosuppressive agents such as cyclosporine and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) is a serious complication of immunosuppressive therapy use following solid organ or stem cell transplants. Clinical findings including headache, mental status changes, focal neurological deficits, and/or visual disturbances. Associated with these are characteristic imaging features of subcortical white matter lesions on computed tomography (CT) or magnetic resonance imaging (MRI). The changes in the subcortical white matter are secondary to potentially reversible vasogenic edema, although conversion to irreversible cytotoxic edema has been described. These imaging findings predominate in the territory of the posterior cerebral artery. Many studies have shown that the neurotoxicity associated with tacrolimus may occur at therapeutic levels. In most cases of PRES, the symptom complex is reversible by reducing the dosage or withholding the drug for a few days. While PRES is an uncommon complication, it is associated with significant morbidity and mortality if it is not expeditiously recognized. MRI represents the most sensitive imaging technique for recognizing PRES. This report highlights the value of MRI in prompt recognition of this entity, which offers the best chance of avoiding long-term sequelae.
Item Type:
Article
Language:
en
Description:
With increasing numbers of solid organ and hematopoietic stem cell transplantations being performed, there have been significant increases in the use of immunosuppressive agents such as cyclosporine and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) is a serious complication of immunosuppressive therapy use following solid organ or stem cell transplants. Clinical findings including headache, mental status changes, focal neurological deficits, and/or visual disturbances. Associated with these are characteristic imaging features of subcortical white matter lesions on computed tomography (CT) or magnetic resonance imaging (MRI). The changes in the subcortical white matter are secondary to potentially reversible vasogenic edema, although conversion to irreversible cytotoxic edema has been described. These imaging findings predominate in the territory of the posterior cerebral artery. Many studies have shown that the neurotoxicity associated with tacrolimus may occur at therapeutic levels. In most cases of PRES, the symptom complex is reversible by reducing the dosage or withholding the drug for a few days. While PRES is an uncommon complication, it is associated with significant morbidity and mortality if it is not expeditiously recognized. MRI represents the most sensitive imaging technique for recognizing PRES. This report highlights the value of MRI in prompt recognition of this entity, which offers the best chance of avoiding long-term sequelae.
MeSH:
Adolescent; Diffusion Magnetic Resonance Imaging; Female; Humans; Immunosuppressive Agents; Neurotoxicity Syndromes; Tacrolimus; Tomography, X-Ray Computed
ISSN:
1438-1435

Full metadata record

DC FieldValue Language
dc.contributor.authorHodnett, Pen
dc.contributor.authorCoyle, Jen
dc.contributor.authorO'Regan, Ken
dc.contributor.authorMaher, M Men
dc.contributor.authorFanning, Nen
dc.date.accessioned2012-01-06T15:53:42Z-
dc.date.available2012-01-06T15:53:42Z-
dc.date.issued2009-11-
dc.identifier.citationPRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy. 2009, 16 (6):493-6 Emerg Radiolen
dc.identifier.issn1438-1435-
dc.identifier.pmid19096887-
dc.identifier.doi10.1007/s10140-008-0782-6-
dc.identifier.urihttp://hdl.handle.net/10147/200776-
dc.descriptionWith increasing numbers of solid organ and hematopoietic stem cell transplantations being performed, there have been significant increases in the use of immunosuppressive agents such as cyclosporine and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) is a serious complication of immunosuppressive therapy use following solid organ or stem cell transplants. Clinical findings including headache, mental status changes, focal neurological deficits, and/or visual disturbances. Associated with these are characteristic imaging features of subcortical white matter lesions on computed tomography (CT) or magnetic resonance imaging (MRI). The changes in the subcortical white matter are secondary to potentially reversible vasogenic edema, although conversion to irreversible cytotoxic edema has been described. These imaging findings predominate in the territory of the posterior cerebral artery. Many studies have shown that the neurotoxicity associated with tacrolimus may occur at therapeutic levels. In most cases of PRES, the symptom complex is reversible by reducing the dosage or withholding the drug for a few days. While PRES is an uncommon complication, it is associated with significant morbidity and mortality if it is not expeditiously recognized. MRI represents the most sensitive imaging technique for recognizing PRES. This report highlights the value of MRI in prompt recognition of this entity, which offers the best chance of avoiding long-term sequelae.en
dc.description.abstractWith increasing numbers of solid organ and hematopoietic stem cell transplantations being performed, there have been significant increases in the use of immunosuppressive agents such as cyclosporine and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) is a serious complication of immunosuppressive therapy use following solid organ or stem cell transplants. Clinical findings including headache, mental status changes, focal neurological deficits, and/or visual disturbances. Associated with these are characteristic imaging features of subcortical white matter lesions on computed tomography (CT) or magnetic resonance imaging (MRI). The changes in the subcortical white matter are secondary to potentially reversible vasogenic edema, although conversion to irreversible cytotoxic edema has been described. These imaging findings predominate in the territory of the posterior cerebral artery. Many studies have shown that the neurotoxicity associated with tacrolimus may occur at therapeutic levels. In most cases of PRES, the symptom complex is reversible by reducing the dosage or withholding the drug for a few days. While PRES is an uncommon complication, it is associated with significant morbidity and mortality if it is not expeditiously recognized. MRI represents the most sensitive imaging technique for recognizing PRES. This report highlights the value of MRI in prompt recognition of this entity, which offers the best chance of avoiding long-term sequelae.-
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshDiffusion Magnetic Resonance Imaging-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshImmunosuppressive Agents-
dc.subject.meshNeurotoxicity Syndromes-
dc.subject.meshTacrolimus-
dc.subject.meshTomography, X-Ray Computed-
dc.titlePRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy.en
dc.typeArticleen
dc.contributor.departmentDepartment of Radiology, Cork University Hospital and University College Cork, Cork, Ireland.en
dc.identifier.journalEmergency radiologyen
dc.description.provinceMunster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.