title: Reversible symmetric polyneuropathy with paraplegia after heart transplantation.
abstract: BACKGROUND
  Neurotoxicity is a well-recognized side effect of cyclosporine therapy in transplant recipients. Cyclosporine can cause a wide range of adverse effects on both the central and peripheral nervous systems.
  
  
  METHODS
  We present a case history of symmetric polyneuropathy with flaccid paraplegia, a rare neurological complication of cyclosporine administration.
  
  
  RESULTS
  Blood levels of the drug above the therapeutic range accompanied the neurological manifestations. The syndrome subsided fully with dose reduction. Patients' symptoms were attributed to axonal degeneration of the peripheral nerves, according to electromyography findings.
  
  
  CONCLUSIONS
  Cyclosporine neurotoxicity should always be considered in patients with neurological complications following transplantation. The case presented in this article illustrates an additional potential mechanism of this adverse effect, namely, axonal degeneration of the peripheral nerves, causing symmetric polyneuropathy.
authors.affiliation: Alexandra Hospital, Department of Clinical Therapeutics, Athens Medical School, Greece.
authors.forename: I V
authors.initials: IV
authors.lastname: Terrovitis
authors.forename: S N
authors.initials: SN
authors.lastname: Nanas
authors.forename: A K
authors.initials: AK
authors.lastname: Rombos
authors.forename: G
authors.initials: G
authors.lastname: Tolis
authors.forename: J N
authors.initials: JN
authors.lastname: Nanas
mesh_terms: D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004576:Electromyography; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010264:Paraplegia / Q000139:chemically induced* / Q000175:diagnosis; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis; D011182:Postoperative Care; D011183:Postoperative Complications
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine