Pseudotumor cerebri following cyclosporine A treatment in a boy with tubulointerstitial nephritis associated with uveitis

Vij, Oliver; Hudde, Tobias; Hoyer, Peter F.; Vester, Udo

doi:10.1007/s00467-004-1429-9

Cited by 32 publications

(17 citation statements)

References 16 publications

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“…In the presence of low serum concentrations, an idiosyncratic effect has been reported. 6,9,17 The clinical manifestations result from ICH. In the study by Phillips 8, the following symptoms were found at presentation: headache (86%); nauseas (46%); decrease in visual acuity (37%); vomiting and fatigue (31%); diplopia (29%); transient visual obscuration (20%); strabismus and photophobia (9%); and pulsatile tinnitus (6%).…”

Section: Discussionmentioning

confidence: 99%

Pseudotumor cerebral associado ao uso de ciclosporina após transplante renal

Costa¹,

Almeida²,

Félix³

et al. 2010

J. Bras. Nefrol.

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Pseudotumor cerebri (PC) is a syndrome characterized by the presence of intracranial hypertension (ICH) and no alteration in the ventricular system. Renal transplanted patients seem more susceptible to develop it due to immunosuppressive therapy. Cyclosporin (CsA) is a rare cause of PC, scarcely reported in the literature, and should be considered in the differential diagnosis of ICH and papilledema in those patients. We report the case of a 10-year-old boy, with a renal allograft for three years, on chronic use of mycophenolate mophetil (MMF), CsA, and low doses of prednisone. The patient presented with headache, vomiting, diplopia, and photophobia. Funduscopy showed bilateral papilledema. Cerebrospinal fluid analysis and imaging tests were normal. After excluding secondary causes, PC was diagnosed based on the chronic use of CsA, which was then replaced by sirolimus. After that, the patient progressively improved, and the papilledema resolved in three months.

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Section: Discussionmentioning

confidence: 99%

Pseudotumor cerebral associado ao uso de ciclosporina após transplante renal

Costa¹,

Almeida²,

Félix³

et al. 2010

J. Bras. Nefrol.

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“…It has been speculated that CsA might affect microvasculature. 11 However, the relationship between serum CsA levels and toxicity is inconsistent and papilledema is an idiosyncratic response to CsA. 12 Both patients described above, developed PTC while on CsA for preventing GvHD.…”

Section: Discussionmentioning

confidence: 96%

“…CsA was also found to be a risk factor for developing PTC after successful renal transplant 10 or during treatment of tubulointerstitial nephritis. 11 It remained unclear how CsA might cause PTC. It has been speculated that CsA might affect microvasculature.…”

Section: Discussionmentioning

confidence: 99%

Pseudotumor Cerebri After Allogeneic Bone Marrow Transplant Associated With Cyclosporine A Use for Graft-Versus-Host Disease Prophylaxis

Somech

Doyle²

2007

Journal of Pediatric Hematology/Oncology

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Pseudotumor cerebri (PTC) is a syndrome of increased intracranial pressure for which several risk factors have been described. We report 2 patients who developed PTC after cyclosporine A (CsA) therapy for graft-versus-host disease (GvHD) prevention after bone marrow transplant. Both patients were obese which may have also contributed to the PTC. Cessation of CsA and combinations of mycophenolate mofetil or tacrolimus and systemic steroids and/or acetazoleamide were effective in managing the symptoms, improving the ocular complications and keeping GvHD asymptomatic. These cases suggest that induction of PTC by CsA used for GvHD prophylaxis in patients undergoing bone marrow transplant is not rare. Physicians who are following patients on CsA need to be alert to the possibility of PTC. Prompt diagnosis followed by thorough evaluation and treatment are crucial for preventing visual loss and improving associated symptoms.

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“…Perhaps CsA induces a susceptible background upon exposure to antibiotics, sulphamidics, steroids, or weight gain. 2,11,15,16 Francis et al reported that the response to medical management, such as acetazolamide or repeated lumbar puncture, was satisfactory in pediatric renal transplantation. In contrast, acetazolamide can result in worsening of renal function, metabolic acidosis, and renal stones.…”

Section: Discussionmentioning

confidence: 99%

“…10,15 But in renal transplantation, discontinuing a calcineurin inhibitor is associated with graft failure. Thus, we switched from CsA to tacrolimus and the PTC resolved within 6 months.…”

Section: Discussionmentioning

confidence: 99%

Successful Switch to Tacrolimus in a Patient with Pseudotumor Cerebri Following Cyclosporine a Treatment in Renal Transplantation

Lee

Jung

Rim

et al. 2009

Dialysis & Transplantation

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We report a case involving a 26‐year‐old Asian woman who developed pseudotumor cerebri (PTC) 2 years after renal transplantation. Cyclosporine A (CsA) was the only medication with a known neurotoxic side effect among her medications. CsA was discontinued and substituted with tacrolimus. After the CsA had been stopped, the elevated intracranial pressure gradually decreased and the bilateral papilledema finally normalized within 6 months. The case described herein is the first case of PTC that improved after renal transplantation by switching from CsA to tacrolimus.

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Pseudotumor cerebri following cyclosporine A treatment in a boy with tubulointerstitial nephritis associated with uveitis

Cited by 32 publications

References 16 publications

Pseudotumor cerebral associado ao uso de ciclosporina após transplante renal

Pseudotumor cerebral associado ao uso de ciclosporina após transplante renal

Pseudotumor Cerebri After Allogeneic Bone Marrow Transplant Associated With Cyclosporine A Use for Graft-Versus-Host Disease Prophylaxis

Successful Switch to Tacrolimus in a Patient with Pseudotumor Cerebri Following Cyclosporine a Treatment in Renal Transplantation

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