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AIM To investigate the clinical features of tacrolimus-related epilepsy, and provide reference for clinical rational antiepileptic drug use. METHODS Related domestic and foreign databases (both up to June 2023) were searched, and case-report literature on tacrolimus-related epilepsy were collected. Clinical information was extracted and analyzed by descriptive statistical method, including patient’s basic characteristics, tacrolimus application (such as indications, dose, route of administration, and blood concentration), and the occurrence time, clinical manifestation, imaging characteristics, intervention measures, and outcomes of epilepsy. RESULTS A total of 11 patients were enrolled in the study, including 6 males and 5 females, aged from 2 years 11 months to 63 years, with a median age of 44 years. In terms of indications, there were 2 cases of hematopoietic stem cell transplantation, 3 cases of kidney transplantation, 4 cases of liver transplantation,1 case of nephrotic syndrome, and 1 case of primary membranous nephropathy. Nine patients underwent tacrolimus plasma concentrations testing, and 3 of them exceed the upper limit of the treatment window when seizure occurred. Epilepsy mainly appeared in d1 to d44 of tacrolimus use. MRI examination in 4 patients showed abnormal signal shadows near the sickle, mild demyelinating of white matter, and patchy abnormal signals around the lateral ventricles. CONCLUSION Tacrolimus-related epilepsy are primarily caused by increased blood concentrations of tacrolimus. It is essential to strengthen the monitoring in clinical application of tacrolimus and provide active symptomatic treatment.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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