Reversible symmetric polyneuropathy with paraplegia after heart transplantation.

BACKGROUND

Neurotoxicity is a well-recognized side effect of cyclosporine therapy in transplant recipients. Cyclosporine can cause a wide range of adverse effects on both the central and peripheral nervous systems.

METHODS

We present a case history of symmetric polyneuropathy with flaccid paraplegia, a rare neurological complication of cyclosporine administration.

RESULTS

Blood levels of the drug above the therapeutic range accompanied the neurological manifestations. The syndrome subsided fully with dose reduction. Patients' symptoms were attributed to axonal degeneration of the peripheral nerves, according to electromyography findings.

CONCLUSIONS

Cyclosporine neurotoxicity should always be considered in patients with neurological complications following transplantation. The case presented in this article illustrates an additional potential mechanism of this adverse effect, namely, axonal degeneration of the peripheral nerves, causing symmetric polyneuropathy.