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The patient was a
28 years old male. He had been followed up with FMF- related
amyloidosis during 2002 – 2008, which resulted him in his renal
failure. He received kidney transplant from his mother in 2008. He
had been using colchicine, deltacortil 5 mg, tacrolimus 2x15mg,
mycophenolate mofetil 2×500 mg and L-Thyroxine 100 mcg 1×1. He was
hospitalized because of his elevated liver enzymes & creatinine
kinase, abdominal pain and diarrhea which was diagnosed to be an
ADR’s from colchicine overdose. Antral gastritis and alkaline reflux
was diagnosed on esophagogastroduodenoscopy along with minimal
intestinal wall edema in the left abdomen. He was started on
meropenem 3×1 which was later changed to cefepime 3×1 and 3×10 mg/kg
acyclovir was also added to treatment as a possible differential
diagnosis for herpetic and opportunistic encephalitis .

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The patient also
had complaint of headache (occipital and bilateral frontal regions),
blurred vision, nausea, vomiting
and speech impairment during the follow up period. After a day
followed by his symptoms he had generalized seizures for which his
neurologist prescribed him oxcarbazepine 2×150 mg. He also vomitted
an ascaris lumbricoides the same day for which he was treated with
mebendazole 3×100 mg for 3 days. His brain CT scan showed
intracerebral hematoma or opportunistic infection in the right
occipital lobe. Later his brain MRI was done in which PRES was
diagnosed. Mycophenolate mofetil was withdrawn and everolimus 2×0.75
mg was continued as to prevent the ADRs from the previous drug. His
blood pressure was strictly monitored with amlodopin 1×10 mg.
Oxcarbazepine was stopped 2 months later and the patient had recoverd
from his post kidney transplant ADRs.