title: FK506-induced fulminant leukoencephalopathy after single-lung transplantation.
abstract: FK506 is being used increasingly to prevent rejection after organ transplantation. Its use is associated with a wide spectrum of neurotoxicity, which has been described after most solid organ transplantations, but reports after lung transplantation are extremely rare. This is a report of the pathologic correlation of the clinical and radiologic features of delayed FK506-induced fulminant leukoencephalopathy after single-lung transplantation. The patient presented with neurologic symptoms that progressed to seizure activity. Neuroimaging showed diffuse changes in the brain, and results of a brain biopsy were consistent with leukoencephalopathy with microglial and astrocytic activation. The patient had a remarkable improvement in clinical status after discontinuation of FK506 administration, with resolution of the changes seen on neuroimaging.
authors.affiliation: Division of Cardiopulmonary Surgery, Oregon Health Sciences University, Portland 97201, USA.
authors.forename: G K
authors.initials: GK
authors.lastname: Thyagarajan
authors.forename: A
authors.initials: A
authors.lastname: Cobanoglu
authors.forename: W
authors.initials: W
authors.lastname: Johnston
mesh_terms: D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016040:Lung Transplantation; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus