Damage to the central nervous system after
transplantation of haemopoietic cells resulting from cyclosporine toxicity
Horáková J.1, Lukáč J.1, Šufliarska S.1, Boďová I.1, Sýkora P.2, Payerová J.2
1II. detská klinika Detskej fakultnej nemocnice s poliklinikou, Bratislava 2Neurologické oddelenie Detskej fakultnej nemocnice s poliklinikou, Bratislava |
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Summary:
Cyclosporine-A is an effective immunosuppressant, given for haemopoietic cell transplantation both
in prophylaxis and in therapy of the graft-versus-host disease. Introduction of cyclosporine-A improved
the results and survival of patients after transplantation. Its administration has, besides immunosuppressive
effects, also adverse effects such as gingival hyperplasia, hypertrichosis, hepatotoxicity,
nephrotoxicity, hypertension and neurotoxicity. This work presents 3 patients following allogenous
HLA-identical transplantation of haemopoietic cells, in whom neurotoxicity of grade III developed
during cyclosporine-A usage. Cyclosporine-A was in all patients given in prophylaxis and later also in
therapy of the graft-versus-host disease. Neurotoxicity manifested itself as epileptic seizure with
impaired consciousness, aphasia and postictal hemiparesis. After early discontinuation of cyclosporine-
A, the clinical symptoms, as well as CT and MRI changes in the brain, regressed completely in all the
patients.
Key words:
cyclosporine-A, neurotoxicity, haemopoietic cell transplantation, graft-versus-host disease
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