A Case of Cyclosporine Induced Reversible Cortical Blindness.
- Author:
Jae Hyun KOH
1
;
Hong Ghi LEE
;
Yun Jae CHUNG
;
Sang Su BAE
;
Hyun Kyun KI
;
Dae Won SEO
;
Hye Kyung YUN
;
Jong Tae LEE
;
Hyun Sik JEONG
;
Won Seog KIM
;
Sung Soo YOON
;
Won Ki KANG
;
Keunchil PARK
;
Chan Hyung PARK
Author Information
1. Division of Hemato-Oncology, Samsung Medical Center, College of Medicine, SungKyunKwan University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Cyclosporine;
Cortical blindness;
Bone marrow transplant
- MeSH:
Adolescent;
Anemia, Aplastic;
Ataxia;
Blindness, Cortical*;
Bone Marrow;
Bone Marrow Transplantation;
Brain;
Central Nervous System;
Cholesterol;
Cyclosporine*;
Electroencephalography;
Evoked Potentials, Visual;
Female;
Humans;
Kidney;
Liver;
Magnesium;
Magnetic Resonance Imaging;
Organ Transplantation;
Paraparesis;
Peripheral Nervous System Diseases;
Seizures;
Transplants;
Tremor
- From:Korean Journal of Hematology
1997;32(3):487-494
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The immunosuppressive agent, cyclosporine (CSA), has improved the success rate of organ transplantation due to its effectiveness in treating graft versus host diseases. However, as its use has increased, so has the variety of toxicities associated with it, including in the kidney, liver, and central nervous system. The spectrum of neurotoxcity ranges from mild tremor and blurred vision to seizures, ataxia, mental status changes, peripheral neuropathy, and paraparesis. Cortical blindness, an extremely rare form of CSA neurotoxicity, has previously been described in only 15 patients after a bone marrow transplant (BMT). We have experienced a rare case of CSA induced cortical blindness in a 15 year-old girl receiving a bone marrow transplantation for aplastic anemia. Tests showed a high cyclosporine level, a low serum magnesium level, and a low cholesterol. In a brain MRI, we found a diffuse high signal intensity in the parieto-occipital lobe on T2-weighted images. In an awake EEG, there were diffuse slowing waves. A visual evoked potential, performed at the time of initial evaluation, when patient was cortical blind, showed no wave formation in the left occipital recording. After discontinuation of CSA, there was significant improvement of cortical blindness, much improvement in the brain MRI, the brain EEG, and the visual evoked potential.
