Cyclosporine A-associated fatal central nervous system angiopathy in a bone marrow transplant recipient: an autopsy case.
We report here the case of a 32-year-old woman who suffered from a unique angiopathy in the central nervous system (CNS). She died of multiple infarcts in the brain stem and cerebellum during treatment with cyclosporine A after bone marrow transplantation for refractory anemia with excess of blasts. The autopsy findings showed segmental narrowing of the basilar artery, in which circumferential dissection of the internal elastic lamina had occurred. The distal portion of the basilar artery was obstructed by upward dislocation of the dissected intima. Similar angiopathy was also observed at multiple sites along the basilar artery branches. These findings suggest endothelial damage, including vasoconstriction and dissection of the CNS arteries.
Koide
T
T
Department of Pathology, Niigata University, Japan.
Yamada
M
M
Takahashi
T
T
Igarashi
S
S
Masuko
M
M
Furukawa
T
T
Kuroha
T
T
Koike
T
T
Sato
M
M
Tanaka
R
R
Tsuji
S
S
Takahashi
H
H
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D002493:Central Nervous System Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D002536:Cerebral Arteries / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D016572:Cyclosporine / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology
D016572:Cyclosporine