Tacrolimus-associated hemichorea in a post–renal transplant patient: a case report
DOI:
https://doi.org/10.18203/2349-3933.ijam20261092Keywords:
Tacrolimus, Drug induced movement disorder, HemichoreaAbstract
Tacrolimus is a calcineurin inhibitor widely used as maintenance immunosuppression after renal transplantation. Although neurotoxicity is a well-recognized complication of tacrolimus therapy, manifesting as tremor, seizures, posterior reversible encephalopathy syndrome, and encephalopathy, the occurrence of choreiform movements—particularly hemichorea—is exceptionally rare. We report a 32-year-old male who developed acute-onset unilateral chorea one month after renal transplantation while receiving tacrolimus and prednisolone. Laboratory evaluation revealed a markedly elevated tacrolimus trough level, while magnetic resonance imaging (MRI) of the brain demonstrated an old right capsulo-ganglionic hemorrhage, providing a structural vulnerability. The patient improved promptly after reduction of tacrolimus dosing and symptomatic therapy. This case underscores the need to consider tacrolimus-induced neurotoxicity in the differential diagnosis of new-onset movement disorders in transplant recipients.
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