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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:2085-2088, November-December 2003
© 2003 American Society of Neuroradiology

Case Report
PEDIATRICS

Severe Tacrolimus Leukoencephalopathy after Liver Transplantation

Janneke Schuuring^a, Pieter Wesseling^b and Aad Verrips^c

^a Department of Neurology, University Medical Center Nijmegen, Nijmegen, the Netherlands
^b Department of Pathology, University Medical Center Nijmegen, Nijmegen, the Netherlands
^c Department of Pediatric Neurology, University Medical Center Nijmegen, Nijmegen, the Netherlands

Address correspondence to Dr. Aad Verrips, Department of Pediatric Neurology, University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands

Summary: Tacrolimus is an immunosuppressive agent that can show a wide variety of neurologic side effects, including leukoencephalopathy. Although the prognosis is good—after cessation or dose reduction, complete recovery usually occurs—the differentiation with treatable diseases such as progressive multifocal encephalopathy can be difficult, making a stereotactic biopsy of the white matter lesion sometimes necessary. We describe the case of a 12-year-old girl with a severe, reversible tacrolimus-related leukoencephalopathy and only mild histopathologic abnormalities.