中文摘要：

目的：探讨他克莫司在引起人类白细胞抗原（HLA）单倍型相合造血干细胞移植后患者可逆性后部脑病综合征的机制及诊疗方法。方法：回顾性分析某院血液科1例亲缘间HLA单倍型相合造血干细胞移植后发生可逆性后部脑病综合征患者的临床资料,并结合文献进行分析。结果：患者在移植后第89天出现抽搐、意识障碍、视物模糊、高血压等表现;第106天头颅磁共振成像（MRI）显示双侧额颞顶枕叶皮层下、双侧脑室旁多发片状长T1长T2信号影,T2液体衰减反转序列呈高信号。停用他克莫司后症状缓解,再次使用他克莫司后症状反复。给予降血压、改善微循环等对症治疗后症状缓解,复查头颅MRI病灶减少、消失。结论：他克莫司可能引起可逆性后部脑病综合征,及时停用他克莫司并有效降压、改善微循环可使病情逆转。

英文摘要：

OBJECTIVE： To discuss the mechanism and treatment method of tacrolimus induced reversible posterior encephalop- athy syndrome （RPES） after HLA haploidentical hematopoietic stem cell transplantation. METHODS： Clinical data of a case of PRES after haploidentical hematopoietic stem cell transplantation was studied retrospectively and related literatures were reviewed. RESULTS： The patient developed an acute onset of seizures, disturbance of consciousness, blurred vision and hypertension 89 days after transplantation. Cranial MRI （on Day 106） showed bilateral frontal, temporal, parietal and occipital subcortical or bilater- al pedventricle with hypointensity on Tl-weighted imaging and hyperintensity on T2- weighted imaging, with hyperintensity on T2-FLAIR imaging. Clinical symptoms were relieved after stopping tacrolimus, and would relapsed when using tacrolimus again. Clinical symptoms were relieved after receiving anti-hypertension and improving microcirculation treatment. MRI lesions were decreased and appeared. CONCLUSIONS： Tacrolimus may cause RPES. The disease condition can be reversed through promptly tacrolimus withdrawal and improvement of microcirculation.