肾移植17年后出现与他克莫司血药谷浓度升高相关的类躁狂性精神病。
Manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant.
作者信息
Bersani Giuseppe, Marino Pietropaolo, Valeriani Giuseppe, Cuoco Valentina, Zitelli Claudia, Melcore Claudia, Bersani Francesco Saverio
机构信息
Department of Medical-Surgical Sciences and Biotechnologies, UOD Fiorini Hospital, Sapienza University of Rome, Viale dell'Universitá No. 30, 00185 Rome, Italy.
出版信息
Case Rep Psychiatry. 2013;2013:926395. doi: 10.1155/2013/926395. Epub 2013 May 16.
Abstract
Several neurological side effects induced by tacrolimus are described in the scientific literature, ranging from mild neurological symptoms to delirium and psychosis. We report the case of a 46-year-old man with no prior psychiatric history who suddenly manifested manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant. The use of antipsychotics may improve the severity of symptoms; but in order to obtain a complete remission, the reduction in the dose of tacrolimus, or its replacement with alternative immunosuppressant therapies, is recommended.
摘要
科学文献中描述了他克莫司引起的几种神经副作用，从轻微的神经症状到谵妄和精神病。我们报告了一例46岁男性病例，该患者既往无精神病史，在肾移植17年后突然出现与他克莫司血药谷浓度升高相关的躁狂样精神病。使用抗精神病药物可能会改善症状的严重程度；但为了实现完全缓解，建议减少他克莫司的剂量，或用替代免疫抑制疗法替代它。
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