Cyclosporine A neurotoxicity in a patient with idiopathic renal magnesium wasting.

Abstract

We report a female child who had idiopathic renal magnesium wasting secondary to suspected Gitleman syndrome and cyclosporine A neurotoxicity after a heart transplant. The child had acute, progressive encephalopathy, intractable seizures, quadriparesis, and extensive, bilateral cortical involvement on neuroimaging. Two days after discontinuation of the cyclosporine, the child's condition improved dramatically, including an improved level of consciousness, and she became seizure free. By 6 weeks, she was fully ambulatory. Follow-up magnetic resonance imaging and electroencephalograms demonstrated significant improvement. This patient had drug-induced neurotoxicity, exacerbated by hypomagnesemia. Cyclosporine should be used cautiously in transplant patients with Gitelman syndrome or other acquired magnesium homeostasis disorders because of the possible increased risk of neurotoxicity. This report is the first case of a patient with both cyclosporine neurotoxicity and magnesium-wasting nephropathy.

• Authors: A K Al-Rasheed, S I Blaser, B A Minassian, L Benson, S K Weiss
• Journal: Pediatric neurology (Pediatr Neurol) Vol. 23 Issue 4 Pg. 353-6 (Oct 2000) ISSN: 0887-8994 [Print] United States
• PMID: 11068171 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Cyclosporine

Topics

• Brain (pathology)
• Child
• Cyclosporine (adverse effects)
• Female
• Heart Transplantation
• Humans
• Immunosuppressive Agents (adverse effects)
• Kidney Diseases (metabolism)
• Magnesium Deficiency (complications)
• Magnetic Resonance Imaging
• Seizures (chemically induced)