Reversible Cerebral Hypoperfusion in Cyclosporine Neurotoxicity: A Case Report.
- Author:
Byeong Cheol AHN
;
Jae Tae LEE
;
Do Young KANG
;
Sang Woo LEE
;
Kyung Ah CHUN
;
Sang Kyun SOHN
;
Kyu Bo LEE
- Publication Type:Case Report
- Keywords:
Cyclosporine;
Neurotoxicity;
Tc-99m ECD;
Brain SPECT;
MRI
- MeSH:
Angiography;
Brain;
Cerebrum;
Cyclosporine*;
Diagnosis;
Female;
Graft vs Host Disease;
Humans;
Lymphoma;
Magnetic Resonance Imaging;
Middle Aged;
Peripheral Blood Stem Cell Transplantation;
Seizures;
Tomography, Emission-Computed, Single-Photon
- From:Korean Journal of Nuclear Medicine
2000;34(4):360-365
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We experienced a case of cerebral hypoperfusion due to cyclosporine neurotoxocity confirmed only by Tc-99m ECD brain SPECT. A 53-year-old female had received allogenic peripheral blood stem cell transplantation due to refractory plasmacytoid lymphoma. Cyclosporine and steroid had been administrated to prevent graft versus host disease. Twenty days after transplantation, she became delirious and suffered from generalized tonic-clonic seizure. Immediately, brain MRI and MR angiography were performed and these studies did not show any abnormal findings. However, Tc-99m ECD brain SPECT showed diffuse hypoperfusion in the left cerebral hemisphere and blood cyclosporine level was 962.6 ng/ml. Cyclosporine administration was stopped and discontinuation of cyclosporine resulted in disappearance of all neurological symptoms. The same neurological symptoms recurred with cyclosporine re-administration for management of exacerbated graft versus host disease. In this case, Tc-99m ECD brain SPECT proved very helpful in the diagnosis of cycloporine neurotoxicity.
