Central nervous lesions in a kidney transplant child

Fernández C,Mártinez-Bermejo A,Espinosa L,Lázaro J,Zarauza A

doi:10.15761/nrd.1000180

Abstract

Central nervous lesions in a kidney transplant child

Highlights

A nine-year-old kidney recipient with stage 3 chronic kidney disease due to poor initial graft perfusion with focal cortical infarcts, cellular rejection, calcineurin inhibitor toxicity and repeated pyelonephritis episodes presented in the Hospital Emergency Service due to a 17-day severe headache that had become more painful and accompanied by vomiting in the last two days
The clinical presentation, tumor-like appearance of the lesion and other data in MR images combined with the negative microbiological results led to a preliminary differential diagnosis of demyelinizing disease vs CNS neoplasia
CNS infections are the main cause of neurological complications in transplant recipients and usually occur in the first-year posttransplant [1]

Summary

Introduction

A nine-year-old kidney recipient with stage 3 chronic kidney disease due to poor initial graft perfusion with focal cortical infarcts, cellular rejection, calcineurin inhibitor toxicity and repeated pyelonephritis episodes presented in the Hospital Emergency Service due to a 17-day severe headache that had become more painful and accompanied by vomiting in the last two days. The clinical presentation, tumor-like appearance of the lesion and other data in MR images combined with the negative microbiological results led to a preliminary differential diagnosis of demyelinizing disease vs CNS neoplasia. Two months later the control MRI (Figure 2) showed a marked decrease in the size of the cerebellar lesion, the disappearance of the mass effect and normal ventricular size.

Results

Conclusion