{
  "abstract": "A 49-year-old woman developed a painful right foot drop that progressed to severe lumbosacral plexopathy, resulting in the inability to walk or stand independently. She had a history of juvenile cystinosis requiring renal transplantation and was taking lifelong immunosuppression (tacrolimus). She also had a monoclonal gammopathy of undetermined significance and diabetes. Extensive investigations, including bone marrow and superficial peroneal nerve biopsy, were non-diagnostic. Her neuropathy progressed despite corticosteroids, involving the upper limbs and causing complete loss of upper limb function. A further brachial plexus biopsy was also non-diagnostic. Tacrolimus was switched to sirolimus after which her pain resolved with functional improvements. Tacrolimus-associated plexopathy is rare but should be considered in patients who have undergone a transplant presenting with progressive neuropathy.",
  "authors": [
    {
      "affiliations": [
        "Department of Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK"
      ],
      "name": "Caroline Kramarz"
    },
    {
      "affiliations": [
        "Department of Transplantation, Guy's and St Thomas’ Hospitals NHS Trust, London, UK"
      ],
      "name": "David Game"
    },
    {
      "affiliations": [
        "Division of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK",
        "Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"
      ],
      "name": "Sebastian Brandner"
    },
    {
      "affiliations": [
        "Department of Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK",
        "Department of Neurology, Guy's and St Thomas’ Hospitals NHS Trust, London, UK"
      ],
      "name": "Alexander Rossor"
    }
  ],
  "title": "Tacrolimus-induced plexopathy",
  "uid": "1a56081e-eaf9-5e66-8b64-25e3cfeb28ef"
}