PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy.
Affiliation
Department of Radiology, Cork University Hospital and University College Cork, Cork, Ireland.Issue Date
2009-11MeSH
AdolescentDiffusion Magnetic Resonance Imaging
Female
Humans
Immunosuppressive Agents
Neurotoxicity Syndromes
Tacrolimus
Tomography, X-Ray Computed
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PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy. 2009, 16 (6):493-6 Emerg RadiolJournal
Emergency radiologyDOI
10.1007/s10140-008-0782-6PubMed ID
19096887Abstract
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
ArticleLanguage
enISSN
1438-1435ae974a485f413a2113503eed53cd6c53
10.1007/s10140-008-0782-6
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