Author Information

An event is serious (FDA MedWatch definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * requires intervention to prevent permanent impairment or damage

A 45-year-old woman developed posterior reversible encephalopathy syndrome (PRES) during treatment tacrolimus [dosage and route not stated].

The woman underwent kidney transplantation and received tacrolimus, prednisone, mycophenolate, antithymocyte globulin. Twenty four hours later, she presented with the complaint of blurred vision and severe headache, which did not response to analgesic drugs. Her blood pressure elevated to 160/90mm Hg. Neurologic examination showed subjective homonymous hemianopsia without focal deficit. Tacrolimus trough level was 8.1 ng/mL. On the basis of above clinical finding, she was diagnosed with PRES.

Tacrolimus was switched to ciclosporin two days after the administration. Four days after the discontinuation of tacrolimus, the woman's symptoms resolved.

Author comment: "We report a patient who presented with early neurotoxicity (24 hours) after initiation of tacrolimus."