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Optic disk swelling and abducens palsies associated with OKT3
M B Strominger1, G T Liu, N J Schatz
1Department of Ophthalmology, University of Nebraska Medical Center, Omaha 68198-2045, USA.
American Journal of Ophthalmology
|May 1, 1995
Summary
Orthoclone OKT3, used for kidney transplant rejection, can cause serious neurological and vision problems like papilledema and abducens palsies. These adverse effects often resolve after discontinuing the drug.
Area of Science:
- Immunology
- Nephrology
- Neurology
- Ophthalmology
Background:
- Orthoclone OKT3 is a murine monoclonal antibody (IgG) utilized to manage acute cellular rejection in organ transplant recipients.
- Known adverse effects include aseptic meningitis and meningoencephalopathy.
- The use of OKT3 in kidney transplant recipients has been associated with other neurological and ophthalmological complications.
Observation:
- An 18-year-old female patient receiving OKT3 for kidney transplant rejection developed papilledema and bilateral deficits in eye abduction.
- Magnetic resonance imaging and angiography revealed no significant abnormalities.
- Lumbar puncture indicated elevated intracranial pressure and sterile meningeal inflammation.
Findings:
- The patient's neurological and ophthalmological symptoms, including papilledema and abducens nerve palsy, were linked to Orthoclone OKT3 treatment.
- Cessation of OKT3 led to the resolution of most symptoms within one week.
Implications:
- Ophthalmologists and neurologists should consider OKT3 as a potential cause of optic disc swelling and abducens palsies in kidney transplant patients.
- Awareness of these potential adverse effects is crucial for timely diagnosis and management in transplant recipients.