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Case Reports
. 2021 Nov 10;10(1):e59-e60.
doi: 10.1055/s-0041-1732344. eCollection 2021 Jan.

CSA-Induced PRES after Heart Transplantation-Report of Two Cases and Review

Katharina Huenges  1 , Philipp Kolat  1 , Bernd Panholzer  1 , Assad Haneya  1
Affiliations
Case Reports

CSA-Induced PRES after Heart Transplantation-Report of Two Cases and Review

Katharina Huenges et al. Thorac Cardiovasc Surg Rep. .

Abstract

Background Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disease possibly associated with the use of calcineurin inhibitors (CNI) like cyclosporine A. Case Description The case of a patient who developed severe PRES under CNI therapy shortly after heart transplantation is presented here. Cerebral computed tomography led to the diagnose of PRES in our patient. New therapy strategy with a quadruple immunosuppressive protocol (cortisone, mycophenolate mofetil, low-dose CNI, and a mechanistic target of rapamycin inhibitor) was started. Conclusion Under the quadruple therapy, a neurologic recovery occurred. In PRES, the presented alternative therapy strategy may lead to improving neurological conditions and preserved transplant organ functions.

Keywords: heart transplantation; immunusuppression; rejection.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Cerebral computed tomography. ( A ) PRES prior to change of immunosuppression with progredient symmetrical leukoencephalopathy. ( B ) CCT prior to discharge with reduced intracerebral lesions. AMR: antibody-mediated rejection; CCT, cerebral computed tomography; CNI, calcineurin-inhibitor; ISHLT, International Society for Heart and Lung Transplantation; LVAD, left ventricular assist device; MMF, mycophenolate mofetil; mTOR, mammalian target of rapamycin; oHTx, orthotopic heart transplantation PRES: posterior reversible encephalopathy syndrome.
See this image and copyright information in PMC

References

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