Resolution of papilledema associated with cyclosporine use after change to tacrolimus.
Acetazolamide
/ therapeutic use
Cyclosporine
/ adverse effects
Diagnosis, Differential
Diuretics
/ therapeutic use
Female
Humans
Immunosuppressive Agents
/ adverse effects
Intracranial Hypertension
/ chemically induced
Intracranial Pressure
/ drug effects
Kidney Transplantation
/ adverse effects
Magnetic Resonance Imaging
Middle Aged
Papilledema
/ chemically induced
Spinal Puncture
/ methods
Tacrolimus
/ therapeutic use
Treatment Outcome
neuroopthalmology
visual pathway
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
19 Nov 2019
19 Nov 2019
Historique:
entrez:
22
11
2019
pubmed:
22
11
2019
medline:
4
4
2020
Statut:
epublish
Résumé
Use of medications including vitamin A derivatives and tetracyclines have been associated with papilledema and raised intracranial pressure. A 46-year-old woman was referred to neuro-ophthalmology for bilateral optic disc oedema and had a 7-year history of cyclosporine use after renal transplantation. She had preserved visual function and moderate bilateral optic disc oedema. Magnetic resonance imaging and magnetic resonance venography of the brain were normal apart from signs of raised intracranial pressure. Lumbar puncture revealed an elevated opening pressure of 40 cm of water with normal cerebrospinal fluid contents. Nephrology was consulted and cyclosporine was switched to tacrolimus and she was treated with acetazolamide. The papilledema resolved within 1 month of her initial visit. It is important to recognise the role that cyclosporine plays in raising intracranial pressure, especially in patients requiring immunosuppression, such as transplant patients. Tacrolimus is a suitable alternative in these cases.
Identifiants
pubmed: 31748372
pii: 12/11/e232725
doi: 10.1136/bcr-2019-232725
pmc: PMC6887480
pii:
doi:
Substances chimiques
Diuretics
0
Immunosuppressive Agents
0
Cyclosporine
83HN0GTJ6D
Acetazolamide
O3FX965V0I
Tacrolimus
WM0HAQ4WNM
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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