A kidney transplant patient on cyclosporine therapy presenting with dural venous sinus thrombosis: a case report

Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report

This study reported two cases of intracranial thrombotic events of aplastic anemia (AA) under therapy with cyclosporine-A (CsA) and reviewed both drug-induced cerebral venous thrombosis (CVT) and CsA-related thrombotic events systematically. We searched PubMed Central (PMC) and EMBASE up to Sep 2019 for publications on drug-induced CVT and Cs-A-induced thrombotic events. Medical subject headings and Emtree headings were used with the following keywords: "cyclosporine-A" and "cerebral venous thrombosis OR cerebral vein thrombosis" and "stroke OR Brain Ischemia OR Brain Infarction OR cerebral infarction OR intracerebral hemorrhage OR intracranial hemorrhage." We found that CsA might be a significant risk factor in inducing not only CVT but also cerebral arterial thrombosis in patients with AA.

Cyclosporin A-related cerebral venous sinus thrombosis: A case report

RATIONALE

Cerebral venous sinus thrombosis (CVST) is a complex life-threatening condition, and its etiology is not well understood. Although oral cyclosporin A is not a common cause of the symptoms related to CVST, there is limited information available.

PATIENT CONCERNS

In this study, we report a rare case of CVST in a 44-year-old woman with aplastic anemia, who was given cyclosporin A orally for a period of 18 months. She had experienced a headache for 20 days.

DIAGNOSES

The patient was diagnosed with CVST by computed tomography venography.

INTERVENTIONS

Low molecular heparin (enoxaparin, 4000 AXaIU, subcutaneous injection, once every 12 hours) was administered for anticoagulation.

OUTCOMES

The patient developed no recurrence of thrombosis during the 13-month follow-up period.

LESSONS

Clinicians should be aware of the possibility of CVST when patients are treated with cyclosporin A and have symptoms such as headaches.