Calcineurin Inhibitor Induced Multiple Infarctions

Tacrolimus is the most commonly used immunosuppressant after kidney transplantation. Here, we report a patient with multiple cerebral infarctions during tacrolimus treatment after kidney transplantation. A 54-year-old female was admitted due to sudden onset right leg weakness. Brain magnetic resonance imaging (MRI) showed multiple acute infarctions but normal vasculature. Evaluations of cardiac embolism were unremarkable. After 8 months, her weakness progressed and follow-up brain MRI showed additional multiple infarctions. We changed here medication from tacrolimus to mycophenolate mofetil, and her symptoms improved gradually.