Article Text

Download PDFPDF
Case report
Encephalopathy in a kidney transplant recipient
  1. Inês Albuquerque1,
  2. Ana Raquel Monteiro2,
  3. Neuza Soares1 and
  4. Susana Ferreira1
  1. 1 Internal Medicine, Centro Hospitalar de Sao Joao EPE, Porto, Portugal
  2. 2 Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
  1. Correspondence to Dr Inês Albuquerque, inescpbalbuquerque{at}


A 60-year-old man presented several times to the emergency department due to confusion and behavioral changes. He was a kidney transplant recipient dependent on hemodialysis due, presumably, to chronic nephropathy of the transplanted kidney, and was not under any immunosuppressive therapy. He was admitted to the hospital ward due to elevation of C reactive protein and severe proteinuria, leukocyturia and erythrocyturia. The alterations found in the spot urine examination were suggestive of nephritic syndrome, consistent with chronic nephropathy of the transplanted kidney. The neurologic deterioration, however, remained unexplained. CT of the brain and cerebrospinal fluid examination were unremarkable. Infection, auto-immune disease and malignancy were excluded. Corticoid therapy was started for rejection nephropathy. The patient improved dramatically and ultimately the transplanted kidney was removed. Chronic nephropathy of the transplanted kidney was confirmed histologically and the patient remained clinically asymptomatic, without corticoid therapy.

  • renal transplantation
  • neurological injury

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All authors were involved in the care for the patient. IA is responsible for writing the manuscript, ARM and NS reviewed the literature and helped with conceptualising it and SF revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.