[Posterior reversible encephalopathy syndrome (PRES) after kidney transplantation: a case report]

Hinyokika Kiyo. 2014 Aug;60(8):387-92.
[Article in Japanese]

Abstract

A 60-year-old woman with chronic renal failure due to a polycystic kidney underwent living kidney transplantation. Initial immunosuppressive therapy consisted of tacrolimus (TAC), mycophenolate mofetil (MMF), prednisolone, and basiliximab. Furthermore, rituximab was administered, and double filtration plasmapheresis and plasma exchange were utilized because of ABO-incompatible transplantation, while intravenous immune serum globulin (IVIG) was given because donor specific antibody was positive. Four days after the renal transplantation, the patient developed visual abnormalities, a headache, and paralysis. Then, he became unconscious. Magnetic resonance imaging of the brain demonstrated bilateral posterior vasogenic edema. Our diagnosis was posterior reversible encephalopathy syndrome due to TAC neurotoxicity. After converting TAC to reduced cyclosporine and everolimus, the symptoms rapidly disappeared.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Living Donors
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Posterior Leukoencephalopathy Syndrome / therapy
  • Tomography, X-Ray Computed