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Table 3 Characteristics and treatment of CSA related neurotoxicity

From: High incidence of severe cyclosporine neurotoxicity in children affected by haemoglobinopaties undergoing myeloablative haematopoietic stem cell transplantation: early diagnosis and prompt intervention ameliorates neurological outcome

Patient number

#1

#2

#3

#4

#5

#6

Day of onset post HSCT

1

5

40

20

7

15

CSA levels (ng/ml)

69

250

194

179

177

150

Mg levels (mEq/l)

0.88

0.86

0.95

0.72

0.85

1.03

Cholesterol and

tryglicerides levels (mg/dl)

123/82

152/64

125/137

195/139

136/162

177/79

Prodromes

headache & vomiting

headache & HTN

HTN

HTN

HTN

HTN & blurred vision

Neurological signs

gen seiz

confusion

gen seiz

gen seiz

gen seiz

blurred vision

Acute treatment

LOR

P

PB

mannitol*

LOR

P

LOR

P

LOR

P

mannitol*

Chronic treatment

P

PB

none

P

P

P

P

CLO

Outcome (day last follow-up

Alive & well

(+1065)

Alive & well

(+1059)

Alive & well

(+1005)

Alive & well

(+760)

Died, grade IV GVHD (+60)

Alive & well

(+320)

  1. Mg = magnesium
  2. HTN = arterial hypertension
  3. gen seiz = generalized seizures
  4. LOR = lorazepam 0.05 mg/kg/dose iv
  5. P = phenitoyn 15 mg/kg/dose iv for acute treatment
  6. phenitoyn 7 mg/kg/day iv for maintenance treatment
  7. PB = Phenobarbital 7 mg/kg/day iv
  8. * 0.5 g/kg/dose iv
  9. CLO = oral clonazepam 0.05 mg/kg/day