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Related Experiment Videos

Reversible bilateral internuclear ophthalmoplegia associated with FK506.

M M Lai1, J B Kerrison, N R Miller

  • 1Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA.

Journal of Neurology, Neurosurgery, and Psychiatry
|April 20, 2004
PubMed
Summary

Calcineurin inhibitors like cyclosporin A and FK506 can cause neurological side effects. This patient experienced seizures with cyclosporin A and vision problems with FK506, both resolving after drug withdrawal.

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Area of Science:

  • Neurology
  • Pharmacology
  • Transplantation

Background:

  • Neurological complications can arise in organ transplant recipients.
  • Calcineurin inhibitors are standard immunosuppressants post-transplant.
  • Monitoring drug toxicity is crucial in managing transplant patients.

Observation:

  • A cardiac transplant patient developed tonic-clonic seizures during cyclosporin A therapy.
  • Seizures resolved upon discontinuation of cyclosporin A.
  • Later, the same patient experienced diplopia due to bilateral internuclear ophthalmoplegia while on intravenous FK506.

Findings:

  • A temporal link was observed between serum FK506 levels and the onset of internuclear ophthalmoplegia.
  • Discontinuation of intravenous FK506 resulted in the prompt resolution of neurological symptoms.

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Implications:

  • This case highlights potential neurotoxicity associated with calcineurin inhibitors.
  • Clinicians should consider neurological monitoring in transplant patients receiving these immunosuppressants.
  • Understanding drug-specific adverse effects is vital for patient management and safety.