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Generalized seizures associated with the use of muromonab-CD3 in two patients after kidney transplantation
R A Seifeldin1, K R Lawrence, A F Rahamtulla
1Department of Pharmacoeconomics, Searle Pharmaceuticals, Skokie, IL 60077, USA.
Objective:
To report two cases of seizures associated with the use of muromonab-CD3.
Case Summary:
Two uremic cadaveric kidney transplant recipients had developed generalized seizures following administration of muromonab-CD3 within the first 2 days after transplantation. Seizures were treated successfully with intravenous phenytoin, and muromonab-CD3 administration was discontinued.
Discussion:
The overall frequency of seizures during muromonab-CD3 administration is 6%. Uremia in patients in the early posttransplant period appears to predispose them to seizures. Seizures that happened to our two uremic patients after transplant suggest that they had been induced by muromonab-CD3 administration. The mechanism of how this could have induced seizures is unknown.
Conclusions:
Prophylactic muromonab-CD3 should be used carefully in uremic kidney transplant recipients following surgery. If therapy with muromonab-CD3 is necessary early hemodialysis should be considered in an effort to lower the risk of seizures.