Cerebellar ataxia in a patient receiving calcineurin inhibitors after living donor liver transplantation: a case report.
Neurological complications of calcineurin inhibitors are frequent problems after transplantation. Cerebellar ataxia with other neurological findings and an abnormal density area in the subcortical white matter are found by MRI in the brains of most patients with central nervous system complications caused by calcineurin inhibitors. Such neurological complications are not life-threatening, but have a negative impact on the quality of life. We describe a 58-year-old woman who developed cerebellar ataxia at 4 days after living donor liver transplantation. She walked with a swaying gait, and after walking for 5 minutes she was unable to stand. Her symptoms persisted after a change from tacrolimus to cyclosporine, but dose reduction of cyclosporine and addition of mycophenolate mofetil cured the ataxia. We diagnosed a case of cerebellar ataxia without leukoencephalopathy or other neurological symptoms, as a new complication of calcineurin inhibitor treatment. We concluded that careful attention should be paid to neurological complications of calcineurin inhibitors.
Yamaguchi
I
I
First Department of Internal Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
Ichikawa
T
T
Nakao
K
K
Hamasaki
K
K
Hirano
K
K
Eguchi
S
S
Takatsuki
M
M
Kawasita
Y
Y
Kanematsu
T
T
Eguchi
K
K
D001921:Brain / Q000473:pathology; D065095:Calcineurin Inhibitors; D002524:Cerebellar Ataxia / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016896:Treatment Outcome
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents