Elsevier

The Annals of Thoracic Surgery

Volume 64, Issue 5, November 1997, Pages 1461-1464
The Annals of Thoracic Surgery

FK506-Induced Fulminant Leukoencephalopathy After Single-Lung Transplantation

https://doi.org/10.1016/S0003-4975(97)00939-9Get rights and content

FK506 is being used increasingly to prevent rejection after organ transplantation. Its use is associated with a wide spectrum of neurotoxicity, which has been described after most solid organ transplantations, but reports after lung transplantation are extremely rare. This is a report of the pathologic correlation of the clinical and radiologic features of delayed FK506-induced fulminant leukoencephalopathy after single-lung transplantation. The patient presented with neurologic symptoms that progressed to seizure activity. Neuroimaging showed diffuse changes in the brain, and results of a brain biopsy were consistent with leukoencephalopathy with microglial and astrocytic activation. The patient had a remarkable improvement in clinical status after discontinuation of FK506 administration, with resolution of the changes seen on neuroimaging.

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Comment

FK506 is being used increasingly in organ transplantation to prevent and treat rejection. Although neurotoxicity of this agent has been described [5] after liver and kidney transplantation, reports after lung transplantation are extremely rare.

The incidence of FK506-induced neurotoxicity, which may be early (<2 weeks) or late (>2 months) [3], varies from 5% to 30% in the literature 3., 4., 5.. The spectrum of neurologic complications may range from mild (tremors, paresthesias, and mild organic

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Copyright © 1997 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.