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肾移植患者接受雷帕霉素治疗后发生的后部可逆性脑病综合征。

Rapamycin-induced posterior reversible encephalopathy in a kidney transplantation patient.

机构信息

Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Int Urol Nephrol. 2011 Sep;43(3):913-6. doi: 10.1007/s11255-010-9757-0. Epub 2010 Jun 1.

DOI:10.1007/s11255-010-9757-0
PMID:20514519
Abstract

BACKGROUND

Posterior reversible encephalopathy syndrome (PRES) is characterized by abnormalities in cerebral white matter and neurologic symptoms. It can be caused by immunosuppressive drugs or autoimmune diseases. We describe a case of PRES in a kidney transplantation patient treated with rapamycin.

CASE

A 24-year-old woman, who received kidney transplantation 8 years ago, presented hypertension (220/120 mmHg), blindness, paralysis of left extremities, vomiting, convulsions and unconsciousness after rapamycin treatment. Magnetic resonance imaging (MRI) showed brain lesions suggestive of PRES. Rapamycin was withdrawn, and repeated MRI indicated progressive resolution within 2 months.

CONCLUSION

Although neurotoxicity of rapamycin is relatively low, it can induce PRES in kidney transplantation patients.

摘要

背景

后部可逆性脑病综合征（PRES）的特征是脑白质异常和神经症状。它可由免疫抑制剂或自身免疫性疾病引起。我们描述了一例肾移植患者在使用雷帕霉素治疗后发生 PRES 的病例。

病例

一名 24 岁女性，8 年前接受肾移植，在使用雷帕霉素治疗后出现高血压（220/120mmHg）、失明、左侧肢体瘫痪、呕吐、抽搐和昏迷。磁共振成像（MRI）显示脑部病变提示 PRES。雷帕霉素被停用，重复 MRI 显示 2 个月内病变逐渐缓解。

结论

尽管雷帕霉素的神经毒性相对较低，但它可在肾移植患者中诱发 PRES。

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