Reversible Ascending Motor Neuropathy as a Side Effect of Systemic Treatment with Ciclosporine for Nodular Prurigo

Rapid improvement of prurigo nodularis with cyclosporine treatment

“…3 Treatment with cyclosporine has been associated with adverse events, including creatinine elevation, hypertension, gastric upset, muscle pains, angioedema, gingival hyperplasia, and neuropathy. 4 Siepmann et al published a report on a series of 14 patients treated with cyclosporine showing a significant response in 13 patients, 7 of whom experienced the aforementioned side effects. 5 We present a retrospective chart review of PN patients seen in the academic medical centerebased practices of 2 physicians (Drs Orlow and Cohen) from 2005-2015 that illustrates the rapid improvement cyclosporine can afford patients with PN.…”

“…To the Editor: The efficacy and safety of omalizumab for the adjunctive treatment of chronic spontaneous urticaria (CSU) is well documented. [1][2][3][4] However, many patients experience disease flare-ups at variable intervals after their last omalizumab dose, and…”

Neurologische Komplikationen antirheumatischer Pharmakotherapeutika

“…Auch milde (Leuko-)Enzephalopathien mit Verwirrtheit und Desorientiertheit (bis 30 % aller Behandelten) [82], Lethargie [22], aber auch schwerere Leukoenzephalopathien [91][92][93] bis zum Vollbild einer PML [94] kommen vor. Weitere neurologische Komplikationen sind multifokale demyelinisierende sensomotorische Polyneuropathien [95], sensible [82], motorische [82,96] und sensomotorische [97] Neuropathien, Engpasssyndrome [98], ein Haltetremor [70] (20-40 % der Behandelten [89]), seltener ein Intentionstremor [82], epileptische Anfälle [22,90] (1,5-6 % der Behandelten [82]), meist holozephale Kopfschmerzen (bis 37 % der Behandelten) [82], zerebellare Störungen mit Ataxie und Dysarthrie [82,90], visuelle Wahrnehmungsstörungen [82,90], pyramidale und extrapyramidale Störungen [82], intrakranielle Druckerhöhung, Retinopathien und Papillenischämie oder -schwellung [82,99], Optikusneuropathien [99,100], kortikale Blindheit und Aphasien [70,90,101]. Insgesamt entwickeln bis zu 40 % der behandelten Patienten meist leichte neurologische Symptome [82,89,93].…”

Drug-induced dysimmune demyelinating neuropathies

“…Rare cases of CsA-associated demyelinating neuropathy have been reported ( Table 2). This review excludes reports confounded by: (a) co-therapy with other immunosuppressant drugs (e.g., muronomab or basiliximab) [99]; (b) suspicion of an etiopathogenic role of concurrent cytomegalovirus re-activation [99,100]; (c) evidence of solid organ rejection [101], or (d) electrodiagnostic evidence of a predominantly axonal variant of Guillain-Barré-like syndrome [93,102,103]. Neuropathy started within weeks of starting CsA, but also occurred years into maintenance treatment.…”