Korean J Hematol.
1997 Nov;32(3):487-494.
A Case of Cyclosporine Induced Reversible Cortical Blindness
- Affiliations
-
- 1Division of Hemato-Oncology, Samsung Medical Center, College of Medicine, SungKyunKwan University, Seoul, Korea.
- 2Department of Internal Medicine, Samsung Medical Center, College of Medicine, SungKyunKwan University, Seoul, Korea.
- 3Department of Neurology, Samsung Medical Center, College of Medicine, SungKyunKwan University, Seoul, Korea.
- 4Department of Radiology, Samsung Medical Center, College of Medicine, SungKyunKwan University, Seoul, Korea.
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.
MeSH Terms
-
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
Cholesterol
Cyclosporine
Magnesium
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