title: Posterior reversible encephalopathy syndrome and graft-versus-host disease after liver transplantation: a case report and review of the literature.
abstract: Case (description): A 52-year-old male patient presented with seizures on the 16th day post liver transplantation suggesting tacrolimus-associated posterior reversible encephalopathy syndrome (PRES). On the 18th day, the patient was diagnosed with graft-versus-host disease (GVHD). Calcineurin inhibitor (CNI) was stopped and the patient received 1 g methylprednisolone and 25 g immunoglobulin. However, on the 21st day, the patient's clinical condition progressively worsened and he died of multi-organ failure. GVHD could have occurred with PRES because the CNI dose was reduced. The best treatment for patients with PRES and GVHD is using immunosuppressants other than CNI. Antibody preparations and steroids could be a standard treatment.
authors.forename: Li-Qin
authors.initials: LQ
authors.lastname: Zhu
authors.forename: Sha-Sha
authors.initials: SS
authors.lastname: Liao
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Jiang
authors.forename: Yi-He
authors.initials: YH
authors.lastname: Liu
mesh_terms: D065095:Calcineurin Inhibitors / Q000009:adverse effects; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000209:etiology* / Q000628:therapy; D016559:Tacrolimus / Q000009:adverse effects
chemical_list: D065095:Calcineurin Inhibitors; D016559:Tacrolimus