Acute disseminated encephalomyelitis after liver transplantation.

BACKGROUND

During the past 10 years, acute disseminated encephalomyelitis has been reported a few times after organ transplantation.

OBJECTIVE

To report a case of acute disseminated encephalomyelitis as a complication of liver transplantation.

DESIGN

Case report.

SETTING

The University of North Carolina Hospital and Medical Center, Chapel Hill. Patient A 49-year-old woman admitted because of acute onset of paresthesias, sensory loss, and weakness after liver transplantation. Acute clinical presentation, results of imaging studies, and comprehensive laboratory evaluation were consistent with acute disseminated encephalomyelitis.

INTERVENTIONS: High-dose intravenous corticosteroid therapy followed by maintenance oral dosing.

MAIN OUTCOME MEASURES: Clinical and magnetic resonance imaging improvement.

RESULTS

Corticosteroid therapy halted clinical progression, with partial resolution of lesions on magnetic resonance images of the brain and spinal cord.

CONCLUSIONS

This is, to our knowledge, the first report of acute disseminated encephalomyelitis after liver transplantation. Possible pathogenic mechanisms include a cross-reactive immune response to foreign antigens present within the transplanted organ, or an inflammatory response triggered by viral infection in an immunocompromised host.