title: Immunosuppression-induced leukoencephalopathy from tacrolimus (FK506)
abstract: Tacrolimus (FK506) has recently been approved for immunosuppression in organ transplantation, although its use is accompanied by a wide spectrum of neurotoxic side effects. We describe the clinical, radiological, and pathological features of 3 cases of tacrolimus-related leukoencephalopathy. The syndrome of immunosuppression-related leukoencephalopathy is proposed as an uncommon neurological syndrome occurring in patients with organ transplants involving demyelination, in particular in the parieto-occipital region and centrum semiovale. Although the syndrome is not associated with a particular (absolute) serum level of tacrolimus, it resolves spontaneously upon decreasing the dose. The tacrolimus-related syndrome has a similar radiographic and pathologic appearance as the analogous syndrome that occurs in patients taking cyclosporine.
authors.affiliation: Department of Neurology, University of Pittsburgh, PA 15261-2003 , USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Small
authors.forename: M B
authors.initials: MB
authors.lastname: Fukui
authors.forename: G T
authors.initials: GT
authors.lastname: Bramblett
authors.forename: B H
authors.initials: BH
authors.lastname: Eidelman
mesh_terms: D000328:Adult; D001766:Blindness / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000503:physiopathology; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000503:physiopathology; D010296:Parietal Lobe / Q000503:physiopathology; D012075:Remission, Spontaneous; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus