[Polyneuropathy and central nervous system diseases before and after heart transplantation. Is cyclosporin neurotoxic?].
In a cross-sectional study, 52 patients (44 men, 8 women, mean age 50.6 [19-68] years) were investigated clinically and electrophysiologically for evidence of peripheral and central nervous system damage before and after heart transplantation. 20 patients were investigated before heart transplantation (group 1), 16 at 7 days to 5 months after transplantation (early post-operative group; group 2) and 16 at 6 to 32 months after transplantation (late post-operative group; group 3). Nerve conduction studies (median, peroneal and sural nerves) revealed polyneuropathy in 14 out of 16 patients in group 2, significantly more than in group 1 (11 out of 19) and group 3 (9 out of 16). The mean blood cyclosporin concentration was 656 ng/ml in group 2 and 409 ng/ml in group 3 (P less than 0.001). Patients in group 3 with polyneuropathy had significantly higher cyclosporin concentrations than patients without polyneuropathy (505 vs 284 ng/ml; P less than 0.01). Among patients who had undergone operations, there were no noteworthy differences between the mean cyclosporin concentrations and clinical data in those with or without central nervous system lesions. There is preliminary evidence of a neurotoxic effect of cyclosporin on the peripheral but not the central nervous system.
Abteilung Psychiatrie, Zentrum Operative Medizin I der Universität Kiel.
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D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000633:toxicity*; D004594:Electrophysiology; D005072:Evoked Potentials, Auditory; D005074:Evoked Potentials, Visual; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D009431:Neural Conduction; D009460:Neurologic Examination; D011183:Postoperative Complications; D013997:Time Factors
D016572:Cyclosporine
Polyneuropathie und zentralnervöse Störungen vor und nach Herztransplantation. Wirkt Ciclosporin neurotoxisch?