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
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.
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