FK506-associated limbic injury following umbilical cord blood transplantation

Abstract

Summary:A 5-year-old girl with Ph-positive chronic myelogenous leukemia, who underwent umbilical cord blood transplantation, developed two episodes of electrical status epilepticus while receiving tacrolimus (FK506) then cyclosporin A (CsA), as treatment against graft-versushost disease. MRI including diffusion weighted MR imaging of the brain revealed abnormalities in the hippocampus and posterior white matter following FK506 and CsA treatment, respectively. While posterior white matter injury has been described with both FK506 and CsA, no previous report describes hippocampal injury from either drug. The MRI changes in the hippocampus in our case suggest possible increased susceptibility to hippocampal injury with FK506.

Evolution of magnetic resonance imaging features in cerebral parenchyma from prolonged focal status epilepticus: a case study

“…The highly enriched distribution of CaN in the dentate gyrus of the hippocampus suggests selective susceptibility of the hippocampus to injury from FK506. One case report showed MRI changes in hippocampal injury associated with tacrolimus [ 10 ], but the causal relationship between epileptic seizures and hippocampal damage from tacrolimus illustrated as high signal intensity of DWI in bilateral hippocampi has not been settled.…”