Reversible acute encephalopathy with mutism, induced by calcineurin inhibitors after renal transplantation.

Abstract

The incidence of neurotoxicity from calcineurin inhibitors varies by the organ transplanted. Akinetic mutism is characterized by the inability to perform voluntary movements and express language, without alterations in mental status. This process has been reported in neurotoxicity due to high serum levels of calcineurin inhibitors, but in rare cases, it presents as a form of tacrolimus toxicity after renal transplantation, despite normal serum levels. We report a clinical case of a renal transplant patient in whom reversible acute encephalopathy and akinetic mutism developed. Brain lesions appeared on magnetic resonance imaging, and the condition resolved after the drug was withdrawn.

• Authors: Katia Toledo Perdomo, María-Dolores Navarro Cabello, María-José Pérez Sáez, Manuel José Ramos Pérez, Maria Luisa Agüera Morales, Pedro Aljama García
• Journal: Journal of nephrology (J Nephrol) 2012 Sep-Oct Vol. 25 Issue 5 Pg. 839-42 ISSN: 1724-6059 [Electronic] Italy
• PMID: 22252846 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Calcineurin Inhibitors
• Immunosuppressive Agents
• Everolimus
• Sirolimus
• Tacrolimus

Topics

• Akinetic Mutism (blood, chemically induced, diagnosis, pathology)
• Biomarkers (blood)
• Brain (drug effects, metabolism, pathology)
• Calcineurin Inhibitors
• Drug Substitution
• Everolimus
• Female
• Humans
• Immunosuppressive Agents (adverse effects, blood, pharmacokinetics)
• Kidney Transplantation (adverse effects, immunology)
• Magnetic Resonance Imaging
• Middle Aged
• Neurologic Examination
• Neurotoxicity Syndromes (blood, diagnosis, etiology, pathology)
• Sirolimus (administration & dosage, analogs & derivatives)
• Tacrolimus (adverse effects, blood, pharmacokinetics)
• Treatment Outcome