Reversible cortical blindness and convulsions with cyclosporin A toxicity in a patient undergoing allogeneic peripheral stem cell transplantation.
A 40-year-old woman underwent allogeneic peripheral blood stem cell transplantation for relapsed AML-M6. She developed graft-versus-host disease on day +15 post-transplant, for which she was treated with cyclosporin A and methyl prednisolone. On day +19 she developed cortical blindness, headache and convulsions which were associated with white matter changes on MRI scanning of the head and elevated cyclosporin A levels. A diagnosis of cyclosporin A encephalopathy was made and cyclosporin A was discontinued. Her vision recovered completely after 48 h and the other symptoms resolved. This is the first case of cyclosporin A encephalopathy to be reported in an allogeneic PBSC recipient.
Madan
B
B
Department of Haematology, Guy's Hospital, London, UK.
Schey
S A
SA
D000328:Adult; D019575:Blindness, Cortical / Q000139:chemically induced*; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D004915:Leukemia, Erythroblastic, Acute / Q000628:therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D012640:Seizures / Q000139:chemically induced*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone