Related Experiment Videos
Recurrent acute inflammatory demyelinating polyradiculitis after allogeneic bone marrow transplantation
W Liedtke1, K Quabeck, D W Beelen
1Department of Neurology, University Hospital of Essen, Germany.
Journal of the Neurological Sciences
|August 1, 1994
Summary
Recurrent acute inflammatory demyelinating polyradiculitis (AIDP) can occur during immunosuppressive therapy for chronic graft-versus-host disease (GVHD). Discontinuing cyclosporin led to sustained neurological improvement in a patient with relapsing AIDP post-bone marrow transplant.
Area of Science:
- Neurology
- Hematology
- Immunology
Background:
- A patient with chronic myelogenous leukemia (CML) underwent allogeneic bone marrow transplantation (BMT) from an unrelated donor.
- The patient developed secondary chronic graft-versus-host disease (GVHD), treated with cyclosporin and prednisone.
- Recurrent acute inflammatory demyelinating polyradiculitis (AIDP) developed during this immunosuppressive treatment.
Observation:
- The patient experienced two relapses of AIDP despite ongoing immunosuppressive therapy.
- Following the second relapse, cyclosporin was discontinued.
- A rapid and sustained improvement in neurological deficits was observed after cyclosporin withdrawal.
Findings:
- Cyclosporin therapy may play a role in the pathogenesis of recurrent AIDP in the context of GVHD post-BMT.
- Systemic cytomegalovirus (CMV) infection was also considered as a potential contributing factor to AIDP.
- Discontinuation of cyclosporin resulted in significant neurological recovery.
Implications:
- This case highlights a potential adverse effect of cyclosporin in patients undergoing BMT for CML.
- Understanding the interplay between immunosuppression, GVHD, and neurological complications like AIDP is crucial.
- Further investigation into the mechanisms linking cyclosporin and AIDP is warranted.