Abstract

ARISTIZABAL, Isabel Cristina Zuluaga et al. Posterior reversible encephalopathy in a child transplanted of heart. CES Med. [online]. 2021, vol.35, n.1, pp.37-43.  Epub Oct 27, 2021. ISSN 0120-8705.  https://doi.org/10.21615/cesmedicina.35.1.4.

Posterior reversible encephalopathy is a clinic-radiological syndrome characterized by arterial hypertension, headache, visual disturbances, seizures and delirium. Radiologically, vasogenic edema is observed in subcortical regions with predilection for the posterior lobes of the brain. It has been associated with solid organ transplantation, arterial hypertension and the use of immunosuppressive drugs such as anticalcineurin. We report the case of a six-year-old boy who started with headache, elevated blood pressure, irritability, aggressiveness and at times agitated five days after receiving an orthotopic heart transplant and one day after starting tacrolimus. His treatment included symptomatic management with antihypertensives and anticonvulsants, in addition to a progressive increase in immunosuppressant to therapeutic blood levels to reduce the risk of graft rejection. Reversible posterior encephalopathy syndrome should be considered in heart transplant recipients receiving calcineurin inhibitors who present neurological symptoms.

Keywords : Posterior Leukoencephalopathy Syndrome; Heart Transplantation; Child Preschool; Tacrolimus..

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