Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
Successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared to maintenance dialysis. We present the case of a 61-year-old woman with chronic kidney disease stage 5-d who received a deceased donor renal transplant. At 21 months after transplantation she developed early post-transplant diabetes and was diagnosed with Pneumocystis jirovecii pneumonia. Her basal creatinine level was 1.1 mg/dL. The patient was admitted with a 7-day history of fever, productive cough, anorexia and right hand altered mobility and sensibility. She was diagnosed with Aspergillus fumigatus pneumonia and the encephalocranial magnetic resonance was suggestive of posterior reversible encephalopathy syndrome, possibly related to high tacrolimus serum levels. Approximately a month later, a renal ultrasound scan and further abdomen computed tomography scan (CT) suggested a tumour and the patient was submitted to right nephrectomy. After discharge, she has been regularly evaluated, maintaining a stable serum creatinine of 2.3 mg/dL, no symptoms associated. This clinical case highlights the myriad of potential complications that transplant recipients are vulnerable to when receiving immunosuppressive therapy.
| Main Authors: | , , , , |
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| Format: | Digital revista |
| Language: | English |
| Published: |
Sociedade Portuguesa de Nefrologia
2015
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| Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200008 |
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