Spontaneous Cauda Equina Syndrome in a Renal Transplant Patient with Long-term Azathioprine Treatment.
- Author:
Bok Jin HYOUNG
1
;
Yeon Joo CHUN
;
Hee Yeon LEE
;
Ji Han YU
;
Eun Suk ROH
;
Su Hyun KIM
;
Chul Woo YANG
;
Yong Su KIM
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yangch@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Cauda equina syndrome;
Kidney transplantation;
Azathioprine
- MeSH:
Adult;
Azathioprine*;
Back Pain;
Biopsy;
Blood Cell Count;
Bone Marrow;
Cauda Equina*;
Follow-Up Studies;
Hematoma;
Humans;
Hypesthesia;
Immunosuppressive Agents;
Kidney Transplantation;
Lower Extremity;
Male;
Pancytopenia;
Polyradiculopathy*;
Steroids;
Tacrolimus;
Transplantation
- From:The Journal of the Korean Society for Transplantation
2007;21(1):143-146
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Azathioprine is a conventional immunosuppressant in renal transplantation but long-term administration may lead to hematologic complications. We here report a cauda equina syndrome caused by spontaneous epidural hematoma in a renal transplant recipient who had undergone long-term azathioprine treatment. A 34 year-old male was admitted to our hospital with complaints of numbness of the lower extremities and back pain. He had received renal transplantation 14 years ago and had been on sole therapy with azathioprine for 11 years. Three months before admission, the patient developed pancytopenia, and a subsequent bone marrow biopsy revealed hypocellularity. Azathioprine was replaced by tacrolimus and steroids thereafter. After a three months discontinuation of azathioprine, an epidural hematoma developed and resulted in cauda equina syndrome. Regular follow-up of complete blood count and change of immunosuppressants with less bone marrow toxicity should be considered in patients receiving azathioprine for long-term period.
