J Korean Soc Transplant.  2007 Jun;21(1):143-146.

Spontaneous Cauda Equina Syndrome in a Renal Transplant Patient with Long-term Azathioprine Treatment

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yangch@catholic.ac.kr

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.

Keyword

Cauda equina syndrome; Kidney transplantation; Azathioprine

MeSH Terms

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
Azathioprine
Immunosuppressive Agents
Steroids
Tacrolimus
Full Text Links
  • JKSTN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr