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Journal of Pediatric Neurology 2023; 21(05): 365-370
DOI: 10.1055/s-0042-1745778
Case Report

Pediatric Tacrolimus-Induced Reversible Cerebral Vasoconstriction Syndrome after Heart Transplantation

Leah Shabo
1   University of Virginia School of Medicine, Charlottesville, Virginia, United States
,
Mariam Ishaque 
2   Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States
,
Danyas Sarathy
1   University of Virginia School of Medicine, Charlottesville, Virginia, United States
,
Jeyan Kumar
2   Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States
,
Kathryn Xixis
3   Department of Neurology, University of Virginia, Charlottesville, Virginia, United States
,
Min Park
2   Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States
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Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare post-organ transplantation complication. While uncommon, complications of post-transplant RCVS can be devastating, with sequelae including ischemic or hemorrhagic stroke and potential significant neurological morbidity. There is a paucity of literature on tacrolimus-mediated RCVS, particularly in the pediatric population. To date, only five case reports have been published, with the youngest patient being 15 years of age. We report the youngest case to date of post-heart transplant tacrolimus-induced RCVS in a 6-year-old male. The present case highlights the necessity of urgent imaging in suspected cases of RCVS, the potential diagnostic challenges surrounding the etiology of headache, the benefits of treating underlying cerebral vasospasm, and the importance of rapid discontinuation of the offending agent for the remission of symptoms and prevention of long-term sequelae.

Keywords

reversible cerebral vasoconstriction syndrome - post-heart transplant - tacrolimus

Note

Consent was obtained from the patient's family to include relevant medical information and imaging in this report.




Publication History

Received: 10 November 2021

Accepted: 20 February 2022

Article published online:
22 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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