[Central pontine myelinolysis associated with cyclosporin in liver transplantation].

Abstract

Liver transplant is the only effective treatment in the terminal liver disease. However, the complexity of the surgical technique and immunosuppression cause many neurologic complications. Three liver transplant recipients treated with cyclosporine developed a reversible neurologic syndrome characterized by early dysarthria, which evolved to anarthria, and tetraparesis. Brain MRI disclosed hyperintense lesions, on T2, and proton density-weighted images, in basis pontis. The substitution of the cyclosporine for FK 506, or its reduction, led to the clinical improvement of the patients. Therefore, cyclosporine may cause central pontine myelinolysis, being dysarthria the first manifestation of neurotoxicity. The early recognition of speech disorders in liver transplant recipients that receive cyclosporine should prompt withdrawal of the drug to avoid possible neurological sequelae. Furthermore, the strict control of natremias before and after the transplant may help to reduce the incidence of this type of complications, since a synergyc osmotic mechanism cannot be ruled out.

• Authors: J Rodríguez, J Benito-León, J A Molina, A Ramos, F Bermejo
• Journal: Neurologia (Barcelona, Spain) (Neurologia) Vol. 13 Issue 9 Pg. 437-40 (Nov 1998) ISSN: 0213-4853 [Print] Spain
• Vernacular Title: Mielinólisis central pontina asociada a ciclosporina en el trasplante hepático.
• PMID: 9883020 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Cyclosporins
• Enzyme Inhibitors

Topics

• Adult
• Aged
• Cyclosporins (adverse effects)
• Enzyme Inhibitors (adverse effects)
• Graft Rejection (drug therapy)
• Humans
• Liver Transplantation
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Myelinolysis, Central Pontine (chemically induced, pathology)