肝移植后他克莫司诱导的后部可逆性脑病综合征与心力衰竭：一例报告
Posterior reversible encephalopathy syndrome and heart failure tacrolimus-induced after liver transplantation: A case report.
作者信息
Liu Jun-Fang, Shen Tian, Zhang Yun-Tao
机构信息
Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
出版信息
World J Clin Cases. 2020 Jul 6;8(13):2870-2875. doi: 10.12998/wjcc.v8.i13.2870.
BACKGROUND
Patients undergoing liver transplantation can develop posterior reversible encephalopathy syndrome (PRES) and acute heart failure (HF) in the post-operative period. But PRES with HF caused by tacrolimus has rarely been described.
CASE SUMMAR
A 40-year-old female patient who had a normal preoperative cardiac and neural evaluation developed PRES with acute heart failure tacrolimus-induced after liver transplantation. The challenges associated with both diagnosis and management in the setting of a newly implanted graft are discussed.
CONCLUSION
Tacrolimus can induce neurotoxicity and then cardiac toxicity. Magnetic resonance imaging, echocardiography, and increased brain natriuretic peptide may be predictive of post-operative PRES with acute heart failure. Further investigations are necessary to verify this finding.
背景
接受肝移植的患者在术后可能会出现后部可逆性脑病综合征（PRES）和急性心力衰竭（HF）。但由他克莫司引起的伴有心力衰竭的PRES鲜有报道。
病例摘要
一名40岁女性患者，术前心脏和神经评估正常，肝移植后因他克莫司诱发急性心力衰竭而出现PRES。讨论了在新植入移植物情况下诊断和管理所面临的挑战。
结论
他克莫司可诱发神经毒性，进而导致心脏毒性。磁共振成像、超声心动图以及脑钠肽升高可能预示术后伴有急性心力衰竭的PRES。需要进一步研究来验证这一发现。
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