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心脏移植术后的后部可逆性脑病综合征:诊断与免疫抑制治疗

Posterior Reversible Encephalopathy Syndrome after Heart Transplantation: Diagnosis and Immunosuppressive Therapy.

作者信息

Kapoor Aniruddh, Birks Emma, Lenneman Andrew, McCants Kelly

出版信息

Tex Heart Inst J. 2017 Jun 1;44(3):205-208. doi: 10.14503/THIJ-15-5007. eCollection 2017 Jun.

Abstract

Posterior reversible encephalopathy syndrome, an infrequent neurotoxicity associated with the use of tacrolimus, was first described in 1996, as a reversible syndrome manifested by headache, altered mental function, seizures, and visual disturbances. We describe the case of a 37-year-old woman who developed neurologic symptoms consistent with encephalopathy after treatment with tacrolimus, which was prescribed to maintain immunosuppression after orthotopic heart transplantation. This report also discusses the imaging methods used in the diagnosis of posterior reversible encephalopathy and highlights the difficulty of maintaining immunosuppression and managing medication-related adverse effects, while taking into account the risk of acute rejection after transplantation.

摘要

后部可逆性脑病综合征是一种与使用他克莫司相关的罕见神经毒性,于1996年首次被描述,是一种以头痛、精神功能改变、癫痫发作和视觉障碍为表现的可逆性综合征。我们报告一例37岁女性病例,该患者在原位心脏移植后使用他克莫司维持免疫抑制治疗后出现了与脑病相符的神经症状。本报告还讨论了用于诊断后部可逆性脑病的影像学方法,并强调了在考虑移植后急性排斥风险的同时,维持免疫抑制和处理药物相关不良反应的困难。

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