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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