Late onset cyclosporine-induced cerebral blindness with abnormal SPECT imagings in a patient undergoing unrelated bone marrow transplantation.
A 23-year-old woman underwent HLA-matched unrelated BMT for CML. She developed cerebral blindness on day 81. Brain magnetic resonance imaging revealed hyperintensity on a T2-weighted image in the white and gray matter of the right frontal and both occipital lobes. Single-photon emission computed tomography (SPECT) was consistent with a decrease in radionuclide uptake in these areas, suggesting a vasoconstrictive mechanism. A diagnosis of CsA-induced encephalopathy was made and CsA was discontinued. Her vision recovered completely after 24 h and abnormal imaging resolved within 2 weeks. This case demonstrates late onset CsA-induced cerebral blindness with the previously unreported abnormalities on SPECT.
Fifth Department of Internal Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
N
N
Uoshima
T
T
Karasuno
T
T
Yagi
S
S
Kawamoto
T
T
Hasegawa
M
M
Yasumi
M
M
Murakami
H
H
Teshima
H
H
Nakamura
A
A
Hiraoka
T
T
Masaoka
D000368:Aged; D019575:Blindness, Cortical / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging; D016026:Bone Marrow Transplantation / Q000276:immunology*; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D009778:Occipital Lobe / Q000000981:diagnostic imaging; D012075:Remission, Spontaneous; D015899:Tomography, Emission-Computed, Single-Photon
D007166:Immunosuppressive Agents; D016572:Cyclosporine