Enhancement of Procoagulant Activity in Stimulated Mononuclear Blood Cells and Monocytes by Cyclosporine

Carlsen, Erik; Prydz, Hans

doi:10.1097/00007890-198704000-00018

Cited by 34 publications

(16 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CsA has been shown to cause direct vascular endothelial damage Correspondence: Dr H Tezcan, North Idaho Cancer Center, 700 Ironwood Drive, Coeur d'Alene, ID 83814, USA Received 18 July 1997; accepted 13 August 1997 and to alter the ratio of thromboxane to prostacyclin production resulting in procoagulant activity. [18][19][20][21][22][23][24] Since patients who develop neurologic symptoms attributable to CsA without microangiopathic changes and those who develop TTP are frequently early post-transplant, discontinuing CsA may be associated with development of severe GVHD. The introduction of FK506 into clinical use has allowed substitution of FK506 for CsA in patients developing TTP following BMT and solid organ transplantation.…”

mentioning

confidence: 99%

Severe cerebellar swelling and thrombotic thrombocytopenic purpura associated with FK506

Tezcan

Zimmer

Fenstermaker

et al. 1998

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Two patients with CsA-associated neurotoxicity developed severe cerebellar swelling and thrombotic thrombocytopenic purpura after switching to FK506 and high-dose corticosteroids. The prodrome of CsAassociated neurotoxicity, TTP and hypertension while receiving FK506, and high-dose corticosteroids could all be implicated in the development of this syndrome. Close monitoring of patients receiving FK506 and highdose corticosteroids, for the development of TTP is warranted. Early radiological examination should also be considered in such patients to allow early surgical intervention. Keywords: cerebellar swelling; TTP; FK506; cyclosporine neurotoxicity; steroids Common side-effects of cyclosporin A (CsA) include renal dysfunction, hypertension and tremors.1,2 Rare severe neurotoxicity including ataxia and occipital blindness is also reported. [3][4][5][6] This syndrome resembles thrombotic thrombocytopenic purpura (TTP). There are numerous case reports of TTP following BMT. [7][8][9][10][11][12][13] Clinical manifestations include: hypertension, edema, renal failure, neurologic changes and microangiopathic hemolytic anemia. Although the syndromes are both associated with CsA use, the presence or absence of microangiopathic hemolytic anemia can distinguish them. 14 Treatment of CsA neurotoxicity consists of discontinuing the drug, correcting electrolyte abnormalities and controlling hypertension. 3,13,15 Neurologic changes typically resolve within 48 h of discontinuing CsA. In contrast, patients with TTP have a much poorer outcome despite discontinuing CsA, often requiring intensive support.14 Although ideal management is unclear, it appears that plasma exchange alone 16 or combined with protein immunoadsorption may be effective modes of therapy. and to alter the ratio of thromboxane to prostacyclin production resulting in procoagulant activity. [18][19][20][21][22][23][24] Since patients who develop neurologic symptoms attributable to CsA without microangiopathic changes and those who develop TTP are frequently early post-transplant, discontinuing CsA may be associated with development of severe GVHD. The introduction of FK506 into clinical use has allowed substitution of FK506 for CsA in patients developing TTP following BMT and solid organ transplantation. 25 However, the safety of this approach is not well established as there are now reports of FK506-induced TTP following BMT and solid organ transplantation. 26-28 Case 1A 28-year-old male with Hodgkin's disease received an HLA-matched unrelated donor BMT 2 years after relapsing following an autologous BMT. Conditioning was with thiotepa and carboplatin. He received low-dose intravenous heparin as hepatic veno-occlusive disease (VOD) prophylaxis. GVHD prophylaxis consisted of cyclosporine, methotrexate and methylprednisolone. On day +8, he developed hyperbilirubinemia (primarily direct), associated with an elevated CsA level of 514 (normal range, 250-450). CsA was held and restarted at one-third the previous dose on day +10. On day +11, he developed cort...

show abstract

mentioning

confidence: 99%

Severe cerebellar swelling and thrombotic thrombocytopenic purpura associated with FK506

Tezcan

Zimmer

Fenstermaker

et al. 1998

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…This is reported to be associated with small sized graft, misalignment, torsion or kinking of the renal artery. In vitro data also suggest that immunosuppressive drugs like cyclosporine and OKT3 may increase the risk of thrombosis [2]. In our patient we have no information on the use of OKT3.…”

Section: Discussionmentioning

confidence: 73%

Renal Allograft Thrombosis in the Early Post Transplant Period

Budruddin¹,

Salmi²,

Shilpa³

2013

OJNeph

View full text Add to dashboard Cite

Renal allograft thrombosis involving either the renal artery or the veins is a well known entity in clinical practice. This complication of the renal transplant surgery is more common in the early part of the post transplant period and it is usually associated with acute antibody mediated rejection. This more commonly occurs in the paediatric renal transplant and also seems to have some relation to the duration of peritoneal dialysis pretransplant. However, the occurrence of graft thrombosis in isolation without clinical or histological graft rejection is not rare. We encountered a patient in whom the renal allograft thrombosis occurred after 6 weeks of commercial renal transplantation without any histological evidence of rejection.

show abstract

“…28 Após o transplante renal, existe significativo declínio da atividade fibrinolítica 29 e da ativação da proteína C, 30 além de ativação de trombina, plaquetas e da via intrínseca da coagulação quando os pacientes estão imunossuprimidos com ciclosporina. 29,31 As contribuições de cada um destes fatores de risco não foram analisadas no presente estudo e podem ter influenciado significativamente os resultados observados. Além disso, observamos que uma proporção significativamente maior de pacientes que não apresentavam defeito trombofílico recebeu tratamento com hemodiálise antes do transplante.…”

Section: Discussionunclassified

Mutação G20210A no gene da protrombina, fator V de Leiden e anticorpos anticardiolipina não influenciam a sobrevida do enxerto renal após o transplante

Rocha¹,

Galante²,

Alvarez³

et al. 2009

J. Bras. Nefrol.

View full text Add to dashboard Cite

Enhancement of Procoagulant Activity in Stimulated Mononuclear Blood Cells and Monocytes by Cyclosporine

Cited by 34 publications

References 0 publications

Severe cerebellar swelling and thrombotic thrombocytopenic purpura associated with FK506

Severe cerebellar swelling and thrombotic thrombocytopenic purpura associated with FK506

Renal Allograft Thrombosis in the Early Post Transplant Period

Mutação G20210A no gene da protrombina, fator V de Leiden e anticorpos anticardiolipina não influenciam a sobrevida do enxerto renal após o transplante

Contact Info

Product

Resources

About