Marijuana/tacrolimus
Development of posterior reversible encephalopathy syndrome following drug interaction and abuse: case reportA 45-year-old woman developed posterior reversible encephalopathy following concomitant administration of tacrolimus for immunosuppressive therapy and marijuana for abusive purpose [routes and duration of treatment to reaction onset not stated; not all dosages stated].The woman presented to hospital with visual disturbances and confusion. She had undergone liver transplantation 3 years before due to cirrhosis secondary to primary biliary cholangitis. The brain-CT scan and brain MRI were consistent with PRES. She had been receiving immunosuppressive therapy with tacrolimus, sirolimus and prednisone. She also admitted smoking 4gm of marijuana [cannabis] per day for abuse.Tacrolimus was discontinued. Consequently, the woman's visual disturbance and encephalopathy resolved. The occurrence of PRES was associated with tacrolimus and concomitant administration of marijuana for abuse.