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Case No. 355
2014-11-01~2014-11-30
출제자 : 김은희
Hit : 358
| Period | 2014-11-01~2014-11-30 |
|---|---|
| Diagnosis | Tacrolimus-induced RCVS and PRES |
| Clinical information | 52/M C.C) Seizure (POD #4, #8) s/p heart TPL for D-CMP on immunosuppressant (tacrolimus, mycophenolate mofetil, methylPd, basiliximab) |
| Discussion | Tacrolimus-induced RCVS and PRES RCVS and PRES are frequently associated. - reversible brain edema occurs in 8–38% of all cases of RCVS. - multifocal cerebral vasoconstriction has been noted in more than 85% of patients with PRES whenever investigations included angiography Because of the frequent association of PRES with RCVS, it is possible that endothelial dysfunction has a role in both disorders. -endothelial dysfunction of any cause affect the regulation of cerebral arterial tone trigger vasoconstriction subsequent hypoperfusion, breakdown of the BBB vasogenic edema Potential causes of RCVS and PRES -Hypertension -Eclampsia or preeclampsia -Immunosuppressants-eg, cyclosporin, tacrolimus -Treatment with cytotoxic drugs -Autoimmune disease -Infection or sepsis |
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