A case of systemic lupus erythematosus which Parkinsonism was induced by tacrolimus

Abstract

The present case is the first report of a systemic lupus erythematosus patient which has been induced Parkinsonism with the administration of tacrolimus (TAC). A 50-year-old woman was diagnosed as lupus nephritis on September 2003. The patient had been prescribed initially 40 mg/day of prednisolone, then cyclosporine was added on May 2005. One year later, she developed severe headache, so cyclosporine was stopped, and she was prescribed tacrolimus on February 2007. However her severe headache had been disappeared, she experienced rigidity and tremor around September 2007. The Dopamine-transporter-imaging examination reavealed that she had Parkinson's disease. The gene analysis on the genetic background showed her case was the sporadic type? Parkinson's disease. Washing out of Tacrolimus, her Parkinsonism was partially improved. This fact suggested that her Parkinsonism was drug-induced type Parkinsonism. In lupus nephritis patients who have been treated with TAC, a very careful observation should be considered because neurological disorders inducing Parkinsonism may occur. © 2010 The Japan Society for Clinical Immunology.