title: Tacrolimus associated posterior reversible encephalopathy syndrome - a case series and review.
abstract: Tacrolimus is an immunosuppressive drug mainly used to lower the risk of transplant rejection in individuals who are post solid organ or hematopoietic transplantation. It is a macrolide which reduces peptidyl-propyl isomerase activity and inhibits calcineurin, thus inhibiting T-lymphocyte signal transduction and interleukin-2 (IL-2) transcription. It has been associated with Posterior Reversible Encephalopathy Syndrome (PRES), a disease of sudden onset that can present as a host of different symptoms, depending on the affected area of the brain. While infectious causes of encephalopathy must always be entertained, the differential diagnosis should also include PRES in the appropriate context. We report three cases of PRES in patients with acute myeloid leukemia (AML) placed on tacrolimus after receiving a bone marrow transplant (BMT). The focus of this review is to enhance clinical recognition of PRES as it is related to an adverse effect of Tacrolimus in the setting of hematopoietic transplantation.
authors.affiliation: Internal and Hospital Medicine, Moffitt Cancer Center, University of South Florida College of Medicine, 12902 Magnolia Drive, Tampa, Florida 33612-9497, USA.
authors.forename: Susmitha
authors.initials: S
authors.lastname: Apuri
authors.affiliation: Internal and Hospital Medicine, Moffitt Cancer Center, University of South Florida College of Medicine, 12902 Magnolia Drive, Tampa, Florida 33612-9497, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Carlin
authors.affiliation: Department of Neurology, Moffitt Cancer Center, University of South Florida College of Medicine, 12902 Magnolia Drive, Tampa, Florida 33612-9497, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Bass
authors.affiliation: Department of Infectious Diseases. University of South Florida College of Medicine, 12902 Magnolia Drive, Tampa, Florida 33612-9497, USA.
authors.forename: Phuong Thuy
authors.initials: PT
authors.lastname: Nguyen
authors.affiliation: Infectious Diseases and Hospital Epidemiologist, Moffitt Cancer Center, University of South Florida College of Medicine, 12902 Magnolia Drive, FOB-3, Tampa, Florida 33612-9497, USA.
authors.forename: John N
authors.initials: JN
authors.lastname: Greene