title: A unique case of rituximab-related posterior reversible encephalopathy syndrome in a heart transplant recipient with posttransplant lymphoproliferative disorder.
abstract: Rituximab is commonly used as a first line therapy to treat posttransplant lymphoproliferative disorders (PTLDs). It has also proved useful in the management of refractory antibody mediated graft rejection. We report an unusual case in which a heart transplant recipient being treated with rituximab for PTLD developed altered mental status, hallucinations and visual symptoms and magnetic resonance imaging (MRI) findings of symmetrical enhancement suggestive of posterior reversible leukoencephalopathy syndrome (PRES). Resolution of these clinical symptoms and radiological findings after discontinuation of therapy confirmed the diagnosis. This is the first case of PRES seen due to rituximab in a heart transplant recipient. Another unique feature of the case is the development of PRES after second cycle of rituximab as compared to prior reports in nonheart transplant patients in which the syndrome developed after first dose administration. The objective of this case report is to increase the awareness of this rare entity amongst immunocompromised transplant patients.
authors: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors: A
authors: A
authors: Jaiswal
authors: I
authors: I
authors: Sabnani
authors: D A
authors: DA
authors: Baran
authors: M J
authors: MJ
authors: Zucker
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects*; D016027:Heart Transplantation; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced*; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab
keywords: artificial organs/support devices: heart/ventricular assist devices; cancer/malignancy/neoplasia; clinical research/practice; complication; drug toxicity; editorial/personal viewpoint; encephalopathy; heart transplantation/cardiology; hematology/oncology; neurology