Short-course metronidazole-induced reversible acute neurotoxicity in a renal transplant recipient.

We present a case of acute neurotoxicity due to short course of injectable metronidazole given in usual doses to a renal allograft recipient for persistent diarrhea. It responded to withdrawal of the offending drug. Tacrolimus trough concentration did not increase during neurotoxicity, thereby ruling out any metronidazole-tacrolimus interaction. Magnetic resonance imaging of the brain showed widespread osmotic demyelination and its recovery after drug withdrawal. This is the first reported case of a renal transplant recipient developing acute neurotoxicity due to short-term use of metronidazole, without any increase in tacrolimus trough concentrations. PMID: 30588989 [PubMed - in process]
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research

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Authors: Yu YM, Ni QQ, Wang ZJ, Chen ML, Zhang LJ Abstract Kidney transplantation is the treatment of choice for patients with end-stage renal disease, as it extends survival and increases quality of life in these patients. However, chronic allograft injury continues to be a major problem, and leads to eventual graft loss. Early detection of allograft injury is essential for guiding appropriate intervention to delay or prevent irreversible damage. Several advanced MRI techniques can offer some important information regarding functional changes such as perfusion, diffusion, structural complexity, as well as oxygenat...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Abstract Background Non-invasive alternatives to percutaneous renal biopsy are sought for follow-up of renal allografts. Purpose To evaluate the feasibility of intravoxel incoherent motion (IVIM) imaging in monitoring and predicting the function of renal allografts. Material and Methods Thirty-five kidney recipients were examined on a 1.5-T MR unit approximately three and 18 months after transplantation. Based on estimated glomerular filtration rate (eGFR), patients were divided into three groups: improved; declined; and stable graft function. Diffusion parameters were calculated with the use of monoexponential (t...
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research
We report a case of a 54-year-old female patient who developed PTLD after liver and kidney transplantation. Diagnoses: We aimed to analyze the standard diagnosis and follow-up of PTLD with imaging. Radiologists need to be familiar with all imaging modalities when dealing with PTLD, including ultrasonography, computed tomography, magnetic resonance imaging, positron-emission tomography/computed tomography. Interventions: The initial treatment included both reduction of immunosuppression and rituximab. Then the treatment strategy changed to rituximab and chemotherapy. Finally, the treatment strategy combined glucocorti...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
AbstractRenal transplantation is the therapy of choice for patients with end-stage renal diseases. Improvement of immunosuppressive therapy has significantly increased the half-life of renal allografts over the past decade. Nevertheless, complications can still arise. An early detection of allograft dysfunction is mandatory for a good outcome. New advances in magnetic resonance imaging (MRI) have enabled the noninvasive assessment of different functional renal parameters in addition to anatomic imaging. Most of these techniques were widely tested on renal allografts in past decades and a lot of clinical data are available....
Source: Abdominal Imaging - Category: Radiology Source Type: research
ConclusionCombinedqualitative andquantitative DW-MRI might allow physicians to determine the severity of histopathologic findings in biopsies of a high number of kidney transplant patients.Key points•Qualitative DW-MRI is highly specific when predicting the severity of kidney transplant biopsy.•Allografts appearing heterogeneous on ADC are associated with severe histopathologic findings.•Combining qualitative and quantitative DW-MRI parameters improves the classification ’s sensitivity and accuracy.•Kidney transplant biopsies might be spared by combining qualitative and quantitative DW-MRI.
Source: European Radiology - Category: Radiology Source Type: research
Abstract BACKGROUND AND OBJECTIVES: Fibrosis is a major cause of kidney allograft injury. Currently, the only means of assessing allograft fibrosis is by biopsy, an invasive procedure that samples 1 year post-transplant undergoing an allograft biopsy first underwent free-breathing, flow-compensated magnetic resonance elastography on a 3.0-T magnetic resonance imaging scanner. Each patient had serial eGFR measurements after the elastography scan for a follow-up period of up to 1 year. The mean stiffness value of the kidney allograft was compared with both the histopathologic Banff fibrosis score and the rate of eGF...
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
Acute cellular renal allograft rejection (AR) frequently occurs  after kidney transplantations. It is a sterile T-cell mediated inflammation leading to increased local glucose metabolism. Here we demonstrate in an allogeneic model of Brown Norway rat kidneys transplanted into uninephrectomized Lewis rats the successful implementation of the recently developed glucose chemical exchange saturation transfer (glucoCEST) magnetic resonance imaging. This technique is a novel method to assess and differentiate AR.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Technical Notes Source Type: research
AbstractPurposeTo evaluate whether ultrasmall superparamagnetic iron oxide nanoparticle (USPIO)-enhanced magnetic resonance imaging (MRI) can detect allograft rejection in pediatric kidney transplant patients.ProceduresThe USPIO ferumoxytol has a long blood half-life and is phagocytosed by macrophages. In an IRB-approved single-center prospective clinical trial, 26 pediatric patients and adolescents (age 10 –26 years) with acute allograft rejection (n = 5), non-rejecting allografts (n = 13), and normal native kidneys (n = 8) underwent multi-echo T2* fast spoiled gradient-echo (FSPGR...
Source: Molecular Imaging and Biology - Category: Molecular Biology Source Type: research
PurposeTo examine the longitudinal changes of renal perfusion due to acute and chronic renal allograft rejection by using arterial spin labeling (ASL) MRI in translational mouse models of isogenic and allogenic kidney transplantation (ktx). Materials and MethodsAcute rejection was induced by allogenic ktx of C57BL/6 (B6)‐kidney grafts to BALB/c‐recipients with prolonged cold ischemia (CIT) of 60 minutes (n = 13). To induce chronic rejection BALB/c‐kidneys were transplanted into B6‐recipients with short CIT of 30 minutes (n = 22). Isogenic grafts without rejection (n = 14 wi...
Source: Journal of Magnetic Resonance Imaging - Category: Radiology Authors: Tags: Original Research Source Type: research
klar İ, Haberal M Abstract OBJECTIVES: The aim of this study was to evaluate the feasibility of diffusion-weighted magnetic resonance, by comparing imaging in renal allograft recipients for functional assessment of kidney transplants versus imaging of these features in healthy volunteers and kidney donors with native kidneys. MATERIALS AND METHODS: Seventy renal transplant recipients (group A) with stable graft function at postoperative month 1, 40 healthy volunteers (group B), and 40 kidney donors (group C) underwent diffusion-weighted magnetic resonance imaging. An echo-planar diffusion-weighted imaging s...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
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