Naslov
Neurotoxicity that may mimic progressive multifocal leukoencephalopathy in patient with transplanted kidney

Autori
Matijaca, Meri ; Vlašić-Matas, Jadranka ; Janković, Stipan ; Pintarić, Irena ; Marović, Anton

Izvornik
Collegium Antropologicum (0350-6134) 31 (2007), 1; 349-353

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Immunocompromised patient ; Immunosuppressive therapy ; Kidney transplantation ; Neurotoxicity ; Progressive multifocal leukoencephalopathy (pml)

Sažetak
We present the 55-year old woman who has had kidney transplantation three times. She has been treated with immunosuppressive therapy and lamivudine for hepatitis B and C. Nine years after the last transplantation she showed neurological symptoms that presented in the form of confusion and epileptic seizures of the grand mal type. A brain MRI showed large oval zones of hyperintense MR signal in T2- weighted image and hypointense in T1- weighted image around the frontal horns of the lateral ventricles, bilaterally and in both cerebellar hemispheres. After reduction in immunosuppression and the exclusion of lamivudine from therapy, the patient was stable with normal neurological status during the course of next five years. We start from the assumption that the concomitant use of cyclosporin with mycophenolate mofetil and lamivudine, despite normal concentrations of cyclosporin, might cause the accumulation of toxic metabolites and lead to neurotoxicity that mimics PML in a chronic viral environment.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA