Generalized seizures associated with the use of muromonab-CD3 in two patients after kidney transplantation.
OBJECTIVE
To report two cases of seizures associated with the use of muromonab-CD3.


METHODS
Two uremic cadaveric kidney transplant recipients had developed generalized seizures following administration of muromonab-CD3 within the first 2 days after transplantation. Seizures were treated successfully with intravenous phenytoin, and muromonab-CD3 administration was discontinued.


CONCLUSIONS
The overall frequency of seizures during muromonab-CD3 administration is 6%. Uremia in patients in the early posttransplant period appears to predispose them to seizures. Seizures that happened to our two uremic patients after transplant suggest that they had been induced by muromonab-CD3 administration. The mechanism of how this could have induced seizures is unknown.


CONCLUSIONS
Prophylactic muromonab-CD3 should be used carefully in uremic kidney transplant recipients following surgery. If therapy with muromonab-CD3 is necessary early hemodialysis should be considered in an effort to lower the risk of seizures.
Seifeldin
R A
RA
Department of Pharmacoeconomics, Searle Pharmaceuticals, Skokie, IL 60077, USA.
Lawrence
K R
KR
Rahamtulla
A F
AF
Monaco
A P
AP
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000009:adverse effects* / Q000627:therapeutic use; D010672:Phenytoin / Q000627:therapeutic use; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy; D014511:Uremia / Q000601:surgery
D000927:Anticonvulsants; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D010672:Phenytoin