The use of cyclosporine in a boy with a prior episode of posterior encephalopathy.
We report the case of a 12- year-old Japanese boy who was receiving cyclosporine (Cs A) for steroid-dependent nephrotic syndrome despite a prior episode of Cs A-associated posterior encephalopathy. At the third relapsing of nephrotic syndrome, Cs A was initiated. Eight days after the Cs A therapy, the boy was admitted to the University Hospital of Tsukuba because of generalized convulsion. Magnetic resonance imaging (MRI) showed hyperintense lesions involving the bilateral parieto-occipital region. Cs A was discontinued, and cyclophosphamide was started. The boy had a 6-month drug-free period after the cyclophosphamide treatment and then relapsed three more times in the following 5 months. As the prednisolone dosage could not be decreased to less than 2 mg/kg/48 h, the patient was re-challenged with Cs A 1 1/2 years later. Blood pressure and serum Cs A levels were measured frequently, an anti-hypertensive drug was given, and MRI was done four times to detect hyperintense lesions. He has been receiving Cs A for 9 months, and MRI has revealed no abnormalities. At the latest follow-up, dated 12 April 2004, he was in a remissive state of nephrotic syndrome. This is the first report of giving Cs A to a nephrotic child who had a previous history of Cs A-associated posterior encephalopathy.
Nakahara
Chieko
C
Department of Pediatrics, National Hospital Organization Mito Medical Center, Higashihara 3-2-1 Mito, 310-0035, Ibaraki, Japan. c.nakahara.d@mn.hosp.go.jp
Hasegawa
Naoyuki
N
Izumi
Isho
I
Kanemoto
Katsuyosi
K
Iwasaki
Nobuaki
N
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D020258:Neurotoxicity Syndromes / Q000209:etiology* / Q000473:pathology; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D012074:Remission Induction
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone
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