American Journal of Neuroradiology, Vol 18, Issue 10 1935-1938, Copyright © 1997 by American Society of Neuroradiology
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Cerebral complications of murine monoclonal CD3 antibody (OKT3): CT and MR findings
PM Parizel, HW Snoeck, L van den Hauwe, K Boven, JL Bosmans, JW Van Goethem, EA Van Marck, P Cras, AM De Schepper and ME De Broe
Department of Radiology, University of Antwerp (Universitair Ziekenhuis Antwerpen), Belgium.
Treatment of acute renal allograft rejection with mouse monoclonal antibody (OKT3) is associated with systemic and neurologic side effects. We describe cerebral abnormalities in a 13-year-old boy with steroid-resistant renal allograft rejection. After treatment with OKT3, an acute neurologic syndrome developed, including seizures, lethargy, and decreased mental function. CT and MR imaging revealed confluent cerebral lesions at the corticomedullary junction. Contrast-enhanced MR images showed patchy enhancement, indicating blood-brain barrier dysfunction. The diagnosis of OKT3-induced encephalopathy with cerebral edema and capillary leak syndrome was made. Although CT and MR findings are nonspecific, neuroradiologists should be aware of this condition in transplant patients treated with OKT3.
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