Gulmez Ruveyda, Saygili Seha, Yilmaz Esra Karabag, Agbas Ayse, Canpolat Nur
Division of Pediatrics, Diyarbakır SBU Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey.
Division of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Pediatr Nephrol. 2025 Mar;40(3):707-709. doi: 10.1007/s00467-024-06546-8. Epub 2024 Sep 30.
Despite its widespread use in patients undergoing organ transplantation or managing nephrotic syndrome, there is a lack of literature on the acute toxicity of cyclosporine A (CsA). This report presents a case of acute CsA toxicity resulting from an accidental overdose in a 2-year-old boy with steroid dependent nephrotic syndrome. Remarkably, despite a tenfold overdose and elevated trough levels, the patient remained asymptomatic, and the CsA trough level normalized within 48 h with rapid intervention, including discontinuation of CsA, intravenous hydration, and cytochrome P450 induction. This case emphasizes the critical importance of prompt and appropriate management to prevent serious consequences in such scenarios.
尽管环孢素A（CsA）在接受器官移植或治疗肾病综合征的患者中广泛使用，但关于其急性毒性的文献却很缺乏。本报告介绍了一名2岁依赖类固醇的肾病综合征男孩因意外过量服用导致急性CsA毒性的病例。值得注意的是，尽管过量服用了10倍剂量且谷浓度升高，但患者仍无症状，通过包括停用CsA、静脉补液和细胞色素P450诱导在内的快速干预，CsA谷浓度在48小时内恢复正常。该病例强调了在这种情况下及时、恰当处理以预防严重后果的至关重要性。
