Acute disseminated encephalomyelitis after liver transplantation.
BACKGROUND
During the past 10 years, acute disseminated encephalomyelitis has been reported a few times after organ transplantation.


OBJECTIVE
To report a case of acute disseminated encephalomyelitis as a complication of liver transplantation.


METHODS
Case report.


METHODS
The University of North Carolina Hospital and Medical Center, Chapel Hill. Patient A 49-year-old woman admitted because of acute onset of paresthesias, sensory loss, and weakness after liver transplantation. Acute clinical presentation, results of imaging studies, and comprehensive laboratory evaluation were consistent with acute disseminated encephalomyelitis.


METHODS
High-dose intravenous corticosteroid therapy followed by maintenance oral dosing.


METHODS
Clinical and magnetic resonance imaging improvement.


RESULTS
Corticosteroid therapy halted clinical progression, with partial resolution of lesions on magnetic resonance images of the brain and spinal cord.


CONCLUSIONS
This is, to our knowledge, the first report of acute disseminated encephalomyelitis after liver transplantation. Possible pathogenic mechanisms include a cross-reactive immune response to foreign antigens present within the transplanted organ, or an inflammatory response triggered by viral infection in an immunocompromised host.
Lindzen
Eric
E
Department of Neurology, University of North Carolina at Chapel Hill, USA.
Gilani
Ajmal
A
Markovic-Plese
Silva
S
Mann
Douglas
D
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018450:Disease Progression; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D013116:Spinal Cord / Q000473:pathology*
D000305:Adrenal Cortex Hormones; D011239:Prednisolone