Tacrolimus Induced Leukoencephalopathy and Stroke-Like Symptoms: Case Report

A 17-year-old female with sickle cell disease status post a recent stem cell transplant and on tacrolimus developed an acute expressive aphasia, dysphagia, and drooling. Brain MRI revealed diffuse restricted diffusion involving the bilateral corona radiata and areas of white matter in the right cerebral hemisphere most consistent with toxic leukoencephalopathy. Tacrolimus serum concentration was high at 19.3 ng/ml (ref 9-12 ng/ml) for which tacrolimus was discontinued. She was neurologically back at baseline 2 days later with the tacrolimus level improving to 8.2 ng/mL. Following discontinuation and the declining trend of her tacrolimus levels the patient returned to her neurologic baseline and was subsequently switched to mycophenolate mofetil for GVHD immunosuppression.

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Work Title Tacrolimus Induced Leukoencephalopathy and Stroke-Like Symptoms: Case Report
Access
Open Access
Creators
  1. Kelly M. Dopke
  2. Nader El Seblani
  3. Katherine Mercer
  4. Sunil Naik
  5. Gayatra Mainali
  6. Dustin Paul
Keyword
  1. Tacrolimus
  2. Tacrolimus-induced leukoencephalopathy
  3. Toxic leukoencephalopathy
  4. Pediatric neurology
  5. Magnetic resonance imaging
License CC BY 4.0 (Attribution)
Work Type Article
Publisher
  1. Child Neurology Open
Publication Date April 18, 2023
Publisher Identifier (DOI)
  1. https://doi.org/10.1177/2329048X231171011
Deposited January 25, 2024

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Version 1
published

  • Created
  • Added Tacrolmus_stroke-1.pdf
  • Added Creator Kelly Dopke
  • Added Creator Nader El Seblani
  • Added Creator Katherine Mercer
  • Added Creator Sunil Naik
  • Added Creator Gayatra Mainali
  • Added Creator Dustin Paul
  • Published
  • Updated Keyword Show Changes
    Keyword
    • Tacrolimus, Tacrolimus-induced leukoencephalopathy, Toxic leukoencephalopathy, Pediatric neurology, Magnetic resonance imaging
  • Renamed Creator Kelly M. Dopke Show Changes
    • Kelly Dopke
    • Kelly M. Dopke
  • Updated Creator Dustin Paul
  • Updated