Abstract
A 13-year-old girl with nephrotic syndrome (NS) developed acute leucoencephalopathy during combination therapy with cyclosporin A (CyA) and prednisolone (PSL). The patient had a generalized motor seizure followed by coma at 19 days after CyA administration. Magnetic resonance scanning performed on the 1st hospital day revealed white matter lesions in the subcortices of the parietal and occipital lobes, brain stem and cerebellum. These lesions had completely resolved on the 10th hospital day. This episode might be caused by CyA because the clinical course and laboratory data revealed neither inflammation nor other causative factors. To our knowledge, this is the first report of acute leucoencephalopathy during combination therapy with CyA and PSL in a patient with NS.
References
Berden JHM, Hoitsma AJ, Merx JL, Keyser A (1985) Severe central-nervous-system toxicity associated with cyclosporin. Lancet I: 219–220
Russell WW, Joel AB (1988) Neurologic complications of immunosuppressive agents. Neurol Clin 6: 261–278
Niaudet P, Broyer M, Habib R (1991) Treatment of idiopathic nephrotic syndrome with cyclosporin A in children. Clin Nephrol [Suppl] 35: 31–36
Neild GH, Ivory K, Hiramatsu M, Williams DG (1983) Cyclosporin A inhibits acute serum sickness nephritis in rabbits. Clin Exp Immunol 52: 586–594
Meyrier A, Simon P, Perret G, Condamin-Meyrier MC (1986) Remission of idiopathic nephrotic syndrome after treatment with cyclosporin A. BMJ 292: 789–792
Waldo FB, Kohaut EC (1987) Therapy of focal-segmental giomerulosclerosis with cyclosporin A. Pediatr Nephrol 1: 180–182
Ito T (1990) Cyclosporin therapy in renal disease of children. Jpn J Pediatr Assoc 94: 1513–1516
Rubin AM, Harriet K (1987) Cerebral blindness and encephalopathy with cyclosporin A toxicity. Neurology 37: 1072–1076
Lloveras JJ, Larrue V, Suc E, Fourtanier G, Durand D (1990) Leukoencephalopathy after cyclosporin in a liver transplant. Clin Transplant 4: 58–62
De Groen PC, Aksamit AJ, Rakela J, Forbes GS, Krom RAF (1987) Central nervous system toxicity after liver transplantation. N Engl J Med 317: 861–866
Deierhoi MH, Kalayoglu M, Sollinger HW, Belzer FO (1988) Cyclosporin neurotoxicity in liver transplant recipients: report of three cases. Transplant Proc 20: 116–118
Lan RJM, Roche SW, Leung AAW, Greco A, Lange LS (1988) Cyclosporin neurotoxicity in cardiac transplant recipients. J Neurol Neurosurg Psychiatry 51: 1434–1437
Klippel N, Sennesael J, Lamote J, Ebinger G, De Keyser J (1992) Cyclosporin leukoencephalopathy induced by intravenous lipid solution. Lancet 339: 1114
Biff FP, Robert DT (1991) Severe neurologic toxicity induced by cyclosporin A in three renal transplant patients. Am J Kidney Dis 18: 116–121
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shimizu, C., Kimura, S., Yoshida, Y. et al. Acute leucoencephalopathy during cyclosporin A therapy in a patient with nephrotic syndrome. Pediatr Nephrol 8, 483–485 (1994). https://doi.org/10.1007/BF00856540
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00856540