Cyclosporine neurotoxicity in heart transplantation.
The neurotoxic potential of cyclosporine in previous clinical experience has not been considered a significant problem. Recently a significant incidence of severe neurotoxicity has been related to cyclosporine therapy in liver transplant recipients. In our heart transplant program we have observed an unexpectedly high incidence of serious neurologic toxicity, presumably caused by use of cyclosporine. Coma, cerebral hemorrhage, hemiparesis and dysphasia, confusion, and visual hallucinations were reported in four patients. Cyclosporine discontinuation or dose reduction eliminated the neurologic effects in all but one patient. Cyclosporine neurotoxic effects should be suspected in heart transplant recipients with central nervous system syndromes.
Vázquez de Prada
J A
JA
Servicio de Cardiología, Centro Médico Nacional Marqués de Valdecilla Santander, Spain.
Martín-Duran
R
R
García-Monco
C
C
Calvo
J R
JR
Olalla
J J
JJ
González-Vilchez
F
F
Gutierrez
J A
JA
D000328:Adult; D001037:Aphasia / Q000139:chemically induced*; D001379:Azathioprine / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000139:chemically induced*; D003128:Coma / Q000139:chemically induced*; D003524:Cyclosporins / Q000009:adverse effects* / Q000627:therapeutic use; D016027:Heart Transplantation; D006429:Hemiplegia / Q000139:chemically induced*; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged
D003524:Cyclosporins; D001379:Azathioprine