{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:08:02Z","timestamp":1775822882382,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the Child Neurology Society"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tacrolimus is a potent immunosuppressive agent effective in preventing solid organ transplant rejection. It is widely used following allogeneic liver, kidney, heart, and bone marrow transplantation. Tacrolimus\u2010related neurotoxicity, which can present in up to one\u2010third of patients, manifests with a broad clinical spectrum. Neuroradiological features are classically reported as bilateral and symmetrical lesions involving the parietal and occipital lobes, similar to posterior reversible encephalopathy syndrome. Tacrolimus\u2010related toxicity can also affect other parts of the brain, including the brainstem, although isolated brainstem involvement is rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This report describes a patient who had\u00a0tacrolimus\u2010related neurotoxicity with an isolated brainstem lesion in which symptoms resolved with only a brief hold of the tacrolimus. A literature review identified four other pediatric patients who had tacrolimus\u2010associated neurotoxicity with isolated brainstem involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Tacrolimus\u2010associated neurotoxicity with pontine lesions in children is rare. In previously reported patients, tacrolimus was discontinued and neurological symptoms resolved. Our patient developed tacrolimus\u2010associated clinical changes and pontine lesions that improved following a brief hold of the tacrolimus treatment. This girl\u00a0highlights tacrolimus\u2010associated neurotoxicity isolated to the brainstem in pediatric patients and demonstrates that tacrolimus may be safely restarted with careful monitoring and follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns3.70000","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T17:43:28Z","timestamp":1741715008000},"page":"41-45","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tacrolimus\u2010Related Neurotoxicity of the Pons in Children: Review of the Literature and a Case Report"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6839-2098","authenticated-orcid":false,"given":"Amy","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Neurology Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Bilal","family":"Haradwala","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Missouri Columbia School of Medicine Columbia Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Baptiste","family":"Le Pichon","sequence":"additional","affiliation":[{"name":"Department of Neurology Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14091755"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602223340803"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2001.27475"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2021.07.011"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14474"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12255"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2011.01591.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0928"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.07.018"},{"issue":"35","key":"e_1_2_8_11_1","first-page":"600","article-title":"Central Pontine Myelinosis and Osmotic Demyelination Syndrome","volume":"116","author":"Lambeck J.","year":"2019","journal-title":"Deutsches \u00c4rzteblatt International"},{"issue":"1","key":"e_1_2_8_12_1","first-page":"163","article-title":"Resolving MR Features in Osmotic Myelinolysis (Central Pontine and Extrapontine Myelinolysis)","volume":"14","author":"Ho V. B.","year":"1993","journal-title":"American Journal of Neuroradiology"}],"container-title":["Annals of the Child Neurology Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cns3.70000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cns3.70000","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cns3.70000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:26:05Z","timestamp":1775820365000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cns3.70000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/cns3.70000"],"URL":"https:\/\/doi.org\/10.1002\/cns3.70000","archive":["Portico"],"relation":{},"ISSN":["2831-3267","2831-3267"],"issn-type":[{"value":"2831-3267","type":"print"},{"value":"2831-3267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}