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

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    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.
    Issue Date
    2009-11
    MeSH
    Adolescent
    Diffusion Magnetic Resonance Imaging
    Female
    Humans
    Immunosuppressive Agents
    Neurotoxicity Syndromes
    Tacrolimus
    Tomography, X-Ray Computed
    
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    Citation
    PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy. 2009, 16 (6):493-6 Emerg Radiol
    Journal
    Emergency radiology
    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
    ISSN
    1438-1435
    ae974a485f413a2113503eed53cd6c53
    10.1007/s10140-008-0782-6
    Scopus Count
    Collections
    Cork University Hospital

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