Abstract
BackgroundRenal transplant recipients frequently experience neurological complications. Whereas ischemic stroke, cerebral haemorrhage or hypertensive encephalopathy often result from vascular alterations prior to transplantation, other cerebral diseases like CNS infections, primary brain tumors and drug induced neurotoxicity may develop as consequences of the required post-transplant immunosuppressive treatment.Case presentationHere we report on an unusual clinical course of a young kidney transplant recipient with a cluster of fulminant necrotic brain lesions within a period of two months due to thrombotic microangiopathy.ConclusionCerebral ischemia in organ transplant recipients should prompt one to consider thrombotic microangiopathy.
Highlights
Renal transplant recipients frequently experience neurological complications
Neurological complications post transplantation include infections and tumours promoted by the immunosuppressive therapy in general and more frequently, tremor and peripheral neuropathies which are commonly related to the therapy with calcineurin inhibitors [1]
The patient was transferred for anti-hypertensive treatment to the ICU, where he died after developing further cerebral infarctions of the brain stem
Summary
Neurological complications post transplantation include infections and tumours promoted by the immunosuppressive therapy in general and more frequently, tremor and peripheral neuropathies which are commonly related to the therapy with calcineurin inhibitors [1]. Severe calcineurin inhibitor-related side effects occur in 10% and are, mostly, reversible after dose reduction or cessation of the drug. These include decreased responsiveness, hallucinations, delusions, seizures, cortical blindness, and stroke-like episodes [2]. Case presentation A 25-year-old male caucasian patient presented with a 1-week history of left-sided weakness, preceded by general fatigue and progressive forgetfulness in the previous two months. His medical history comprised a kidney transplantation 12 years earlier for end-stage renal failure due to focal and segmental glomerulosclerosis, a. Vasculitits was further excluded by negative results for antinuclear antibodies, ANCA, anti-mitochondrial antibodies,
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