Skip to main content
Log in

Dysarthria and cerebellar ataxia: late occurrence of severe neurotoxicity in a liver transplant recipient

  • Brief Reports
  • Published:
Transplant International

Abstract

Neurological complications of cyclosporin (CyA) therapy are frequent, usually occurring within the 1st month after transplantation. Though leukoencephalopathy is one of them, it is rarely documented. Here we report the case of an anti-HCV-positive patient with cirrhosis who underwent liver transplantation and developed cyclosporin-induced leukoencephalopathy. The presenting symptoms were dysarthria, difficulty walking, and dysphagia. They were first noted 6 months after transplantation in association with an episode of recurrent HCV acute hepatitis. White matter abnormalities were evident on computed tomography (CT) scanning and magnetic resonance (MR) imaging. This condition improved to some degree after cyclosporin withdrawal. To our knowledge this is the second reported case of CyA neurotoxicity occurring late after liver transplantation. Moreover, the association with acute hepatitis suggests the possibility of graft dysfunction as a contributing and triggering factor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Adams DH, Ponsford S, Gunson B, Boon A, Honigsberger L, Williams A, Buckels J, Elias E and McMaster P (1987) Neurological complications following liver transplantation. Lancet I: 949–951

    Google Scholar 

  2. Atkinson K, Biggs J, Darveniza P, Boland J, Concannon A, Dodds A (1984) Cyclosporine associated central nervous system toxicity after allogenic bone marrow transplantation (Letter). N Engl J Med 310:527

    Google Scholar 

  3. Berden JHM, Hoitsma AJ, Merx JL, Keyser A (1985) Severe central nervous system toxicity associated with CyA (Letter). Lancet I:219–220

    Google Scholar 

  4. Bruijn KM de, Klompmaker IJ, Slooff MJH, Fockens P, Hillen PH (1989) Cyclosporine neurotoxicity late after liver transplantation (Letter). Transplantation 47:575

    Google Scholar 

  5. Groen PC de, Aksamit AJ, Rakela J, Forbes JS, Krom RAF (1989) Central nervous system toxicity after liver transplantation: the role of cyclosporine and cholesterol. N Engl J Med 317: 861–866

    Google Scholar 

  6. Groen PC de, Wiesner RH, Krom RAF (1989) Advanced liver failure predisposes to cyclosporine induced central nervous system symptoms after liver transplantation. Transplant Proc 21: 2546

    Google Scholar 

  7. Lloveras JJ, Larrue V, Suc E, Fourtanier G, Durand D (1990) Leucoencephalopathy after cyclosporine in a liver transplant. Clin Transplant 4:58–62

    Google Scholar 

  8. Shah D, Rylance PB, Rogerson ME, Bewick M, Parsons V (1984) Generalised epileptic fits in renal transplant recipients given Cyclosporine. BMJ 289:1347

    Google Scholar 

  9. Thompson CB, June CH, Sullivan KM, Thomas ED (1984) Association between cyclosporine neurotoxicity and hypomagnesemia. Lancet II:1116–1120

    Google Scholar 

  10. Tollemar J, Ringden O, Ericzon BG, Tyden G (1988) Cyclosporine-associated central nervous system toxicity (Letter). N Engl J Med 318:788

    Google Scholar 

  11. Vogt DP, Lederman RJ, Carey WD, Broughan T (1988) Neurologic complications of liver transplantation. Transplantation 45: 1057–1061

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Belli, L.S., De Carlis, L., Romani, F. et al. Dysarthria and cerebellar ataxia: late occurrence of severe neurotoxicity in a liver transplant recipient. Transpl Int 6, 176–178 (1993). https://doi.org/10.1007/BF00336365

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00336365

Key words

Navigation