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Case Records of the Massachusetts General Hospital
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Volume 358:2619-2628 June 12, 2008 Number 24
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Case 18-2008 — A 68-Year-Old Man with Headache and Visual Changes after Liver Transplantation
Margaret Seton, M.D., Misha Pless, M.D., Jay A. Fishman, M.D., Paul A. Caruso, M.D., and E. Tessa Hedley-Whyte, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 68-year-old man was admitted to the hospital because of headache and loss of vision in the right eye. Orthotopic allogeneic liver transplantation had been performed 3 1/2 months earlier because of liver failure due to hepatitis C virus (HCV) infection. Perioperative medications included rabbit antithymocyte globulin, vancomycin, fluconazole, and piperacillin–tazobactam. Tacrolimus, azathioprine, furosemide, spironolactone, and a short course of corticosteroids were administered postoperatively. The immediate postoperative course was complicated by coagulopathy, intraperitoneal thrombi, and worsening renal function, with ascites and peripheral edema. The patient was discharged 2 weeks after transplantation.

He had persistent anorexia and fatigue, but his condition . . . [Full Text of this Article]

Differential Diagnosis

Giant-Cell Arteritis

Anterior Ischemic Optic Neuropathy

Infections after Liver Transplantation

Dr. Margaret Seton's Diagnosis

Pathological Discussion

Anatomical Diagnoses


Source Information

From the Rheumatology, Allergy, and Immunology Division and Rheumatology Unit (M.S.), the Departments of Neurology (M.P.), Infectious Disease (J.A.F.), and Radiology (P.A.C.), and the Neuropathology Division, Department of Pathology (E.T.H.-W.), Massachusetts General Hospital; the Departments of Medicine (M.S., J.A.F.), Neurology (M.P.), Pathology (E.T.H.-W.), and Radiology (P.A.C.), Harvard Medical School; and the Department of Radiology, Massachusetts Eye and Ear Infirmary (P.A.C.).




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