Reversible encephalopathy after cardiac transplantation: histologic evidence of endothelial activation, T-cell specific trafficking, and vascular endothelial growth factor expression.
Reversible encephalopathy after transplantation is well recognized. The condition is commonly thought to be related to immune suppression, and a characteristic brain imaging pattern is typically recognized with vasogenic edema in the parietal and occipital regions, typically termed posterior reversible encephalopathy syndrome (PRES). We report the case of a patient with reversible encephalopathy after cardiac transplantation with brain biopsy evidence of endothelial activation, selective intravascular/perivascular T-cell trafficking, and VEGF expression in astrocytes, neurons, and the endothelium.
Horbinski
C
C
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Bartynski
W S
WS
Carson-Walter
E
E
Hamilton
R L
RL
Tan
H P
HP
Cheng
S
S
D001253:Astrocytes / Q000473:pathology; D001706:Biopsy; D001929:Brain Edema / Q000276:immunology* / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000276:immunology; D004730:Endothelium, Vascular / Q000276:immunology / Q000473:pathology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology; D011183:Postoperative Complications / Q000276:immunology* / Q000473:pathology*; D012333:RNA, Messenger / Q000378:metabolism; D020127:Recovery of Function; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics*
D012333:RNA, Messenger; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A