Central pontine myelinolysis and locked-IN syndrome associated with tacrolimus after pediatric heart transplantation.
Pediatr Transplant
; 27(3): e14474, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-36717958
ABSTRACT
BACKGROUND:
Locked-in syndrome represents the most severe form of central pontine myelinolysis and varies in presentation from asymptomatic to fully developed locked-in-syndrome characterized by the combination of quadriplegia, loss of the ability to communicate except through the use of the eyes, and an inability to follow commands.METHODS:
We report a 10-year-old boy who developed a severe case of locked-in syndrome after heart transplantation.RESULTS:
Patient had a spontaneous recovery, treated with supportive treatment and the improvement was detected with cessation of calcineurin inhibitor therapy by substituting with an mTOR inhibitor (sirolimus). No cases of locked-in syndrome post-heart transplant in pediatrics cases have been documented in the literature.CONCLUSION:
Physicians should recognize a rapid progression of central pontine myelinolysis and locked-in syndrome in the context of heart transplant and although several factors likely contributed to this outcome, adjustment of immunosuppression including by substituting tacrolimus with sirolimus could be effective.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Coração
/
Mielinólise Central da Ponte
/
Síndrome do Encarceramento
Tipo de estudo:
Risk_factors_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Revista:
Pediatr Transplant
Assunto da revista:
PEDIATRIA
/
TRANSPLANTE
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Arábia Saudita