Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Cyclosporin A-induced encephalopathy after allogeneic bone marrow transplantation with prevention of graft-versus-host disease by tacrolimus

Abstract

A 21-year-old woman with severe aplastic anemia received an allogeneic bone marrow transplant (allo-BMT) from an HLA-matched and ABO-matched sibling donor after conditioning with cyclophosphamide, rabbit ATG (Lymphoglobuline; Aventis-Pharma), and total lymphoid irradiation. She had a long history of cyclosporin A (CsA) therapy before conditioning. She complained of severe headache and convulsions on day 0, and findings on magnetic resonance images suggested CsA-induced encephalopathy. CsA was immediately stopped, and tacrolimus for prevention of graft-versus-host disease (GVHD) was started on day 2. Hematological engraftment was observed on day 14 without serious GVHD. Prompt diagnosis, replacement of immunosuppressive agents, and careful monitoring of serum drug concentrations are thought to have contributed to the patient's good clinical course, since CsA-induced encephalopathy tends to be recurrent but to improve completely without any sequelae. Bone Marrow Transplantation (2001) 28, 713–715.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Schwartz RB, Bravo SM, Klufas RA et al. Cyclosporine neurotoxicity and its relationship to hypertensive encephalopathy Am J Radiol 1995 165: 627–631

    CAS  Google Scholar 

  2. Fiorani L, Bandini G, D'Alessandro R et al. Cyclosporin A neurotoxicity after allogeneic bone marrow transplantation Bone Marrow Transplant 1994 14: 175–176

    CAS  PubMed  Google Scholar 

  3. Kochi S, Takanaga H, Matsuo H et al. Effect of cyclosporin A or tacrolimus on the function of blood-brain barrier cells Eur J Pharmacol 1999 372: 287–295

    Article  CAS  PubMed  Google Scholar 

  4. De Groen PC, Aksamit AJ, Rakcla J et al. Central nervous system toxicity after liver transplantation N Engl J Med 1987 317: 861–866

    Article  CAS  PubMed  Google Scholar 

  5. Thompson CB, June CH, Sullivan KM et al. Association between cyclosporin neurotoxicity and hypomagnesaemia Lancet 1984 2: 1116–1120

    Article  CAS  PubMed  Google Scholar 

  6. Teshima T, Miyoshi T, Ono M . Cyclosporine-related encephalopathy following allogeneic bone marrow transplantation Int J Hematol 1996 63: 161–164

    Article  CAS  PubMed  Google Scholar 

  7. Reece DE, Frei-Lahr DA, Shepherd JD et al. Neurologic complications in allogeneic bone marrow transplant patients receiving cyclosporine Bone Marrow Transplant 1991 8: 393–401

    CAS  PubMed  Google Scholar 

  8. Gijtenbeek JM, van den Bent MJ, Vecht CJ . Cyclosporine neurotoxicity: a review J Neurol 1999 246: 339–346

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Takahata, M., Hashino, S., Izumiyama, K. et al. Cyclosporin A-induced encephalopathy after allogeneic bone marrow transplantation with prevention of graft-versus-host disease by tacrolimus. Bone Marrow Transplant 28, 713–715 (2001). https://doi.org/10.1038/sj.bmt.1703221

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703221

Keywords

This article is cited by

Search

Quick links