Belli L S, De Carlis L, Romani F, Rondinara G F, Rimoldi P, Alberti A, Bettale G, Dughetti L, Ideo G, Sberna M
Department of Surgery and Transplantation, Pizzamiglio II, Niguarda Ca Granda Hospital, Milan, Italy.
Transpl Int. 1993 May;6(3):176-8. doi: 10.1007/BF00336365.
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.
环孢素（CyA）治疗的神经系统并发症很常见，通常发生在移植后的第1个月内。虽然白质脑病是其中之一，但很少有文献记载。在此，我们报告1例抗丙型肝炎病毒（HCV）阳性的肝硬化患者，该患者接受了肝移植，并发生了环孢素诱导的白质脑病。其出现的症状为构音障碍、行走困难和吞咽困难。这些症状在移植后6个月首次出现，同时伴有复发性HCV急性肝炎发作。计算机断层扫描（CT）和磁共振成像（MR）显示白质异常。停用环孢素后，病情有一定程度的改善。据我们所知，这是第二例报道的肝移植术后晚期发生的CyA神经毒性病例。此外，与急性肝炎的关联提示移植物功能障碍可能是一个促成和触发因素。
