Cyclosporine A에 의한 급성뇌증 1례

A Case of Cyclosporine A-Induced Encephalopathy in a Child with Nephrotic Syndrome

저자들은 빈발 재발 신증후군으로 cyclosporine A 치료를 받던 환아에서 발병한 cyclosporine A에 의한 급성뇌증으로 의심되는 례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Cyclosporine A is the most frequently used immunosuppressive agent for prevention of graft versus host disease(GVHD) and treatment of frequently relapsing nephrotic syndrome in childhood. Some adverse effects such as hepatic and renal toxicity, have been frequently encountered. But central nervous system toxicity caused by cyclosporine A is rare, and the incidence of encephalopathy among patients receiving cyclosporine A is unknown. Brain magnetic resonance imaging is an essential tool for diagnosis of cyclosporine A neurotoxicity. It typically demonstrates nonenhancing symmetric subcortical, and sometimes deep white matter changes resembling edema with posterior hemisphere predominance. We report a child with nephrotic syndrome who developed encephalopathy during cyclosporine A therapy. Based on this study, we emphasize that careful follow up of patient´s neurological finding is very important to prevent serious life-threatening complications.