Dysarthria and cerebellar ataxia: late occurrence of severe neurotoxicity in a liver transplant recipient.

Abstract

Neurological complications of cyclosporin (CyA) therapy are frequent, usually occurring within the 1st month after transplantation. Though leukoencephalopathy is one of them, it is rarely documented. Here we report the case of an anti-HCV-positive patient with cirrhosis who underwent liver transplantation and developed cyclosporin-induced leukoencephalopathy. The presenting symptoms were dysarthria, difficulty walking, and dysphagia. They were first noted 6 months after transplantation in association with an episode of recurrent HCV acute hepatitis. White matter abnormalities were evident on computed tomography (CT) scanning and magnetic resonance (MR) imaging. This condition improved to some degree after cyclosporin withdrawal. To our knowledge this is the second reported case of CyA neurotoxicity occurring late after liver transplantation. Moreover, the association with acute hepatitis suggests the possibility of graft dysfunction as a contributing and triggering factor.

• Authors: L S Belli, L De Carlis, F Romani, G F Rondinara, P Rimoldi, A Alberti, G Bettale, L Dughetti, G Ideo, M Sberna
• Journal: Transplant international : official journal of the European Society for Organ Transplantation (Transpl Int) Vol. 6 Issue 3 Pg. 176-8 (May 1993) ISSN: 0934-0874 [Print] Switzerland
• PMID: 8499072 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cyclosporine

Topics

• Cerebellar Ataxia (diagnosis, etiology)
• Cyclosporine (adverse effects)
• Dysarthria (etiology)
• Hepatitis C (complications)
• Humans
• Leukoencephalopathy, Progressive Multifocal (diagnosis, etiology)
• Liver Transplantation (adverse effects)
• Magnetic Resonance Imaging
• Male
• Middle Aged