Tacrolimus-Induced Leukoencephalopathy in a Renal Transplantation Patient

Tacrolimus-Induced Leukoencephalopathy in a Renal Transplantation Patient

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Tacrolimus is an immunosuppressant that is frequently used following renal transplantation.Several mild neurological side effects of tacrolimus have been reported in the literature; however, severe complications in the form of confusion, seizures, and coma are rare.Herein, we report a 16-year-old boy on tacrolimus following living-donor kidney transplant, who presented with subacute onset of hand tremors, headache, altered mental status, and mpu63zm/a progressed to akinetic mute state.He was diagnosed with tacrolimus-induced leukoencephalopathy based on findings of his magnetic resonance imaging and ruling out other possible causes.He showed clinical and radiological improvement after discontinuation of tacrolimus.

Radiological here features of tacrolimus-induced leukoencephalopathy are more heterogenous than commonly perceived and should be suspected in such patients.The potential neurotoxicity of tacrolimus should be recognized in patients with renal transplantation, and switching to a different immunosuppressant is warranted to prevent permanent neurological damage.