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Ann Thorac Surg 2002;73:1965-1967
© 2002 The Society of Thoracic Surgeons

Case report

Glucocorticoids and hippocampal atrophy after heart transplantation

Asher P. Wilner, MDa*, Benoit de Varennes, MDa,b,c, Pierre A. Gregoire, PhDa, Sonia Lupien, PhDc, Jens C. Pruessner, PhDc

a Psychiatry, McGill University Health Centre at the Royal Victoria Hospital and the Montreal Neurological Hospital, Montreal, Quebec, Canada
b Cardiothoracic Surgery, McGill University Health Centre at the Royal Victoria Hospital and the Montreal Neurological Hospital, Montreal, Quebec, Canada
c Neurology, McGill University Health Centre at the Royal Victoria Hospital and the Montreal Neurological Hospital, Montreal, Quebec, Canada

Accepted for publication November 1, 2001.

* Address reprint requests to Dr Wilner, Department of Psychiatry, McGill University Health Centre at the Royal Victoria Hospital, 1025 Pine Ave West, Montreal, Quebec H3A 1A1, Canada
e-mail: asher.wilner{at}mcgill.ca

The glucocorticoid cascade hypothesis proposes that hippocampal atrophy may result from excessive steroid exposure. Although demonstrated in animal models and some human hypercortisolemic states, hippocampal damage as a possible consequence of posttransplant steroid immunosuppression has not been investigated in human heart transplant recipients. We report a case of a 37-year-old female heart transplant recipient who had the clinical, neuropsychiatric, and neuroimaging findings consistent with hippocampal atrophy after 5 years of steroid exposure.






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