Tacrolimus (FK506)-induced cerebral blindness following bone marrow transplantation.
Three patients who developed acute onset of cerebral blindness within 5-47 days of BMT using tacrolimus (FK506) as primary GVHD prophylaxis are described. This syndrome has been described with the use of cyclosporin A (CsA) and FK506 in solid organ transplant recipients. CsA-induced cerebral blindness has also been noted in BMT recipients but to date there have been no reports of this complication in BMT patients receiving FK506. We have noted a striking similarity in the clinical and radiographic presentations between these patients and those with CsA-associated cerebral blindness. Reversibility within 1-2 weeks of onset and the potential for substitution of CsA for FK506 in these patients is described.
Devine
S M
SM
Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Newman
N J
NJ
Siegel
J L
JL
Joseph
G J
GJ
Geis
T C
TC
Schneider
J A
JA
Geller
R B
RB
Wingard
J R
JR
D000328:Adult; D001766:Blindness / Q000209:etiology*; D016026:Bone Marrow Transplantation; D001921:Brain / Q000187:drug effects*; D016572:Cyclosporine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus