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Cyclosporine-induced Leukoencephalopathy Precipitated Following Interaction with Ciprofloxacin

Divya Nagabushana1, Supraja Chandrasekhar2, Stalin Ramprakash2

  • 1Department of Neurology, People Tree Hospitals, Bengaluru, Karnataka, India.

Journal of Pediatric Neurosciences
|January 12, 2022
PubMed

Insights

Cyclosporine and ciprofloxacin drug interaction can cause severe neurological issues in bone marrow transplant patients. This case highlights the importance of caution when prescribing antibiotics with cyclosporine.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Transplant Medicine

Background:

  • Cyclosporine is an immunosuppressant commonly used post-transplant.
  • Ciprofloxacin is a broad-spectrum antibiotic.
  • Drug interactions can lead to adverse events, particularly in immunocompromised patients.

Purpose of the Study:

  • To report a case of severe neurotoxicity.
  • To highlight a potential drug interaction between cyclosporine and ciprofloxacin.
  • To emphasize the need for caution in prescribing antibiotics to patients on cyclosporine.

Main Methods:

  • Case report of a bone marrow transplant recipient.
  • Clinical presentation of encephalopathy, hemiparesis, and multiorgan dysfunction.
  • Neuroimaging findings consistent with leukoencephalopathy.

Main Results:

  • The patient developed severe neurological symptoms and multiorgan dysfunction after initiating ciprofloxacin.
  • Imaging confirmed white matter signal changes indicative of cyclosporine leukoencephalopathy.
  • The adverse event was attributed to a drug interaction between cyclosporine and ciprofloxacin.

Conclusions:

  • A significant drug interaction exists between cyclosporine and ciprofloxacin.
  • This interaction can precipitate cyclosporine leukoencephalopathy.
  • Clinicians must exercise caution when co-prescribing antibiotics, especially fluoroquinolones, with cyclosporine.
Keywords:
Ciprofloxacincyclosporineinteractionleukoencephalopathytoxic

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