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Neurotoxicity of cyclosporine A in children with steroid-resistant nephrotic syndrome: is cytotoxic edema really an unfavorable predictor of permanent neurological damage?
- Source :
- Wiener klinische Wochenschrift. 129(15-16)
- Publication Year :
- 2015
-
Abstract
- Cyclosporine A-associated neurotoxicity has been reported mainly after organ transplantation. Only a small number of children with steroid-resistant nephrotic syndrome and cyclosporine A-associated neurotoxicity have been reported. We report three children, aged 4, 11, and 15, with steroid-resistant nephrotic syndrome and cyclosporine A-associated neurotoxicity. In two of the patients, primary diagnosis was idiopathic nephrotic syndrome, and in one it was IgA nephropathy. Magnetic resonance with diffusion-weighted imaging, combined with quantification of apparent diffusion coefficient values, showed lesions caused by cytotoxic edema indicating irreversible brain damage. Nonetheless, the patients fully recovered clinically and radiologically after prompt discontinuation of cyclosporine A. Neurotoxic effects should be suspected in any child with nephrotic syndrome treated with cyclosporine A in whom sudden neurological symptoms occur. Cytotoxic edema is a rare finding in pediatric patients. However, even in such cases with seemingly irreversible brain damage, full recovery without permanent neurological sequels is possible with prompt cyclosporine A discontinuation and supportive therapy.
- Subjects :
- Male
medicine.medical_specialty
Nephrotic Syndrome
Adolescent
030232 urology & nephrology
Drug Resistance
Brain Edema
Brain damage
Gastroenterology
Organ transplantation
Nephropathy
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Medicine
Humans
Child
medicine.diagnostic_test
business.industry
Neurotoxicity
Brain
Magnetic resonance imaging
General Medicine
medicine.disease
Magnetic Resonance Imaging
Steroid-resistant nephrotic syndrome
Discontinuation
030220 oncology & carcinogenesis
Anesthesia
Child, Preschool
Cyclosporine A neurotoxicity, Steroid-resistant nephrotic syndrome, Children
Cyclosporine
Brain Damage, Chronic
Female
medicine.symptom
business
Nephrotic syndrome
Subjects
Details
- ISSN :
- 16137671
- Volume :
- 129
- Issue :
- 15-16
- Database :
- OpenAIRE
- Journal :
- Wiener klinische Wochenschrift
- Accession number :
- edsair.doi.dedup.....601664fcfb3b39a581a2d7da3a5317de