Cyclosporine-induced optic neuropathy, ophthalmoplegia, and nystagmus in a patient with Crohn disease.
OBJECTIVE
To report the cyclosporine-induced complications of optic neuropathy, partial external ophthalmoplegia, and other neurologic abnormalities.


METHODS
Case report. A 22-year-old man with severe active Crohn disease developed bilateral optic neuropathy, nystagmus, external ophthalmoplegia, and ataxia on the fifth day of cyclosporine A (CyA) parenteral therapy.


RESULTS
Cyclosporine therapy was discontinued as soon as toxic clinical manifestations appeared. Cyclosporine blood level detected then was 1,290 ng/ml (therapeutic level: 150 to 300 ng/ml). Partial external ophthalmoplegia improved dramatically; however, the patient's optic neuropathy progressed to optic atrophy, leaving the patient visually impaired. Various possible mechanisms for cyclosporine-induced neurotoxicity are discussed.


CONCLUSIONS
It is important to closely monitor neuro-ophthalmologic and neurologic signs of patients treated with cyclosporine.
Technion School of Medicine, Haifa, Israel.
Y
Y
Porges
S
S
Blumen
Z
Z
Fireman
A
A
Sternberg
D
D
Zamir
D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy*; D016572:Cyclosporine / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D009759:Nystagmus, Pathologic / Q000139:chemically induced*; D009886:Ophthalmoplegia / Q000139:chemically induced* / Q000503:physiopathology; D009896:Optic Atrophy / Q000139:chemically induced* / Q000473:pathology; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine