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Imaging abnormalities were observed in five of six patients during the course of their neurologic illnesses.For each patient,neurologic symptoms began when the tacrolimus level in blood was at a peak,exceeding the therapeutic limit in all but one case.In five patients,neurologic symptoms eventually resolved after the tacrolimus dose was reduced or after the drug was stopped.Multifocal low attenuation of white matter was the predominant finding seen on CT images,and matching hyperintense white matter foci were observed on long-TR MR images.In three patients,clinical recovery was accompanied by reversal of the white matter abnormalities seen on CT and MR images.Immunosuppressive therapy with tacrolimus may produce neurologic side effects that are associated with brain CT and MR imaging abnormalities.Resolution of symptoms and reversal of imaging findings occur when the tacrolimus dose is reduced. |
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