Rapamycin-induced posterior reversible encephalopathy in a kidney transplantation patient

Posterior reversible encephalopathy syndrome (PRES) is characterized by abnormalities in cerebral white matter and neurologic symptoms. It can be caused by immunosuppressive drugs or autoimmune diseases. We describe a case of PRES in a kidney transplantation patient treated with rapamycin. A 24-year-old woman, who received kidney transplantation 8 years ago, presented hypertension (220/120 mmHg), blindness, paralysis of left extremities, vomiting, convulsions and unconsciousness after rapamycin treatment. Magnetic resonance imaging (MRI) showed brain lesions suggestive of PRES. Rapamycin was withdrawn, and repeated MRI indicated progressive resolution within 2 months. Although neurotoxicity of rapamycin is relatively low, it can induce PRES in kidney transplantation patients.