Posterior reversible encephalopathy syndrome and graft-versus-host disease after liver transplantation: a case report and review of the literature

作者：Zhu, Li-Qin; Liao, Sha-Sha; Jiang, Wen-Tao; Liu, Yi-He^*

来源：International Journal of Clinical Pharmacology and Therapeutics, 2015, 53(9): 783-787.

DOI：10.5414/CP202384

• calcineurin inhibitor
• graft-versus-host disease
• liver transplantation
• posterior reversible encephalopathy syndrome

Case (description): A 52-year-old male patient presented with seizures on the 16th day post liver transplantation suggesting tacrolimus-associated posterior reversible encephalopathy syndrome (PRES). On the 18th day, the patient was diagnosed with graft-versus-host disease (GVHD). Calcineurin inhibitor (CNI) was stopped and the patient received 1 g methylprednisolone and 25 g immunoglobulin. However, on the 21st day, the patient's clinical condition progressively worsened and he died of multi-organ failure. GVHD could have occurred with PRES because the CNI dose was reduced. The best treatment for patients with PRES and GVHD is using immunosuppressants other than CNI. Antibody preparations and steroids could be a standard treatment.

• 出版日期2015-9
• 单位天津市第一中心医院; 天津医科大学