التفاصيل البيبلوغرافية
| العنوان: |
Tacrolimus-associated neurotoxicity isolated to the brainstem: two illustrative cases and a systematic review of the literature. |
| المؤلفون: |
Rossi, Simone, Rinaldi, Rita, Asioli, Gian Maria, Barone, Valentina, Pianta, Paolo, Cescon, Matteo, Morelli, Maria Cristina, Faccioli, Luca, Spinardi, Luca, Cortelli, Pietro, Guarino, Maria |
| المصدر: |
Neurological Sciences; Jul2024, Vol. 45 Issue 7, p3107-3115, 9p |
| مصطلحات موضوعية: |
POSTERIOR leukoencephalopathy syndrome, TREMOR, BRAIN stem, HYPERTENSIVE encephalopathy, NEUROTOXICOLOGY |
| مستخلص: |
Introduction: Tacrolimus-associated neurotoxicity (TAN) manifests with wide clinical spectrum, ranging from mild tremors to severe encephalopathy. The isolated involvement of the brainstem is a rarely documented presentation of TAN, and its clinical and diagnostic characteristics are unclear. Methods: We report two cases of brainstem-isolated TAN (bi-TAN). Moreover, we performed a systematic review of the literature on bi-TAN and extracted data concerning demographics, clinical characteristics, radiological features, and management. The systematic literature search followed PRISMA guidelines and a pre-defined protocol. Results: Eleven patients, including our two, were identified (mean age: 41.3 years, ± 18.8; five males, 45%). Speech disturbance was the most common clinical presentation (45%). The mean latency from Tacrolimus initiation to bi-TAN onset was 26 days (± 30.8). Tacrolimus serum level tested above the reference range in three patients (mean: 26.83 ± 5.48). Brain MRI showed T2-FLAIR hyperintensities; three showed restricted diffusion on ADC maps. Neurological symptoms resolved completely in seven patients (63%) after Tacrolimus withdrawal or dose reduction. Conclusions: Our findings suggest that bi-TAN could represent a brainstem variant of posterior reversible encephalopathy syndrome. Recognition of bi-TAN as a potential cause of isolated brainstem lesions is crucial to disentangle the diagnostic work-up and ensure prompt withdrawal or reduction of the offending agent. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
