Cyclosporine A toxicity presenting with acute cerebellar edema and brainstem compression. Case report.
A 38-year-old man receiving cyclosporine A after bilateral lung transplantation for cystic fibrosis presented with cortical blindness, generalized seizures, and cerebellar edema. Progressive brainstem compression necessitated emergency posterior fossa decompression. Replacement of cyclosporine A with an alternative immunosuppressive agent, FK506, was followed by rapid neurological recovery and dramatic resolution of radiographic abnormalities. The etiology, clinical features, and radiographic findings of cyclosporine A neurotoxicity are discussed. The pertinent literature is reviewed.
Nussbaum
E S
ES
Department of Neurological Surgery, University of Minnesota Hospital and Clinic, Minneapolis, USA.
Maxwell
R E
RE
Bitterman
P B
PB
Hertz
M I
MI
Bula
W
W
Latchaw
R E
RE
D000208:Acute Disease; D000328:Adult; D001766:Blindness / Q000139:chemically induced; D001929:Brain Edema / Q000139:chemically induced*; D001933:Brain Stem; D002526:Cerebellar Diseases / Q000139:chemically induced*; D016572:Cyclosporine / Q000506:poisoning* / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000601:surgery; D006801:Humans; D016040:Lung Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011182:Postoperative Care
D016572:Cyclosporine