Gk. Thyagarajan et al., FK506-INDUCED FULMINANT LEUKOENCEPHALOPATHY AFTER SINGLE-LUNG TRANSPLANTATION, The Annals of thoracic surgery, 64(5), 1997, pp. 1461-1464
FK506 is being used increasingly to prevent rejection after organ tran
splantation. Its use is associated with a wide spectrum of neurotoxici
ty, which has been described after most solid organ transplantations,
but reports after lung transplantation are extremely rare. This is a r
eport of the pathologic correlation of the clinical and radiologic fea
tures of delayed FK506-induced fulminant leukoencephalopathy after sin
gle-lung transplantation. The patient presented with neurologic sympto
ms that progressed to seizure activity. Neuroimaging showed diffuse ch
anges in the brain, and results of a brain biopsy were consistent with
leukoencephalopathy with microglial and astrocytic activation. The pa
tient had a remarkable improvement in clinical status after discontinu
ation of FK506 administration, with resolution of the changes seen on
neuroimaging. (C) 1997 by The Society of Thoracic Surgeons.