TY - JOUR T1 - Encephalopathy in a kidney transplant recipient JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-231077 VL - 12 IS - 9 SP - e231077 AU - InĂªs Albuquerque AU - Ana Raquel Monteiro AU - Neuza Soares AU - Susana Ferreira Y1 - 2019/09/01 UR - http://casereports.bmj.com/content/12/9/e231077.abstract N2 - 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. ER -