{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:58:20Z","timestamp":1779217100530,"version":"3.51.4"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2026,4,13]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/pn-2025-005007","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:20:21Z","timestamp":1777396821000},"page":"pn-2025-005007","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Tacrolimus-induced plexopathy"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2480-3590","authenticated-orcid":false,"given":"Caroline","family":"Kramarz","sequence":"first","affiliation":[{"name":"Department of Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Game","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Guy's and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Brandner","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4648-2896","authenticated-orcid":false,"given":"Alexander","family":"Rossor","sequence":"additional","affiliation":[{"name":"Department of Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neurology, Guy's and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026042810201315000_pn-2025-005007v1.1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s40264-024-01398-5","article-title":"Tacrolimus-Induced Neurotoxicity After Transplant: A Literature Review","volume":"47","author":"Verona","year":"2024","journal-title":"Drug Saf"},{"key":"2026042810201315000_pn-2025-005007v1.2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410350422"},{"key":"2026042810201315000_pn-2025-005007v1.3","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880170510"},{"key":"2026042810201315000_pn-2025-005007v1.4","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1002\/mus.70025","article-title":"Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) Developing During Tacrolimus Treatment: A Case Series","volume":"72","author":"Evans","year":"2025","journal-title":"Muscle Nerve"},{"key":"2026042810201315000_pn-2025-005007v1.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2008.00961.x"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2025-005007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:20:21Z","timestamp":1777396821000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2025-005007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":5,"alternative-id":["10.1136\/pn-2025-005007"],"URL":"https:\/\/doi.org\/10.1136\/pn-2025-005007","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]}}}