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2.1
Cyclosporine
Cyclosporin

Images

WIKIDATA, Public Domain
WIKIDATA, Public Domain
WIKIDATA, Public Domain

Presentation

Cyclosporine was effective in decreasing the eosinophil count without the elimination of abnormal T cell clones in the present case. Cytotoxic agents may be necessary to cure this serious disease. [ncbi.nlm.nih.gov]

Present study is largest study using cyclosporin as a treatment for refractory ITP. [haematologica.org]

None of them presented alterations of kidney or liver functions. [bjn.org.br]

Gastrointestinal

  • Nausea

    Shaking, headache, dizziness, unusual growth of body hair, nausea / vomiting, diarrhea, stomach upset, or flushing may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. [webmd.com]

    If you experience unexplained nausea, fatigue, muscle weakness or tingling sensations, contact your doctor, as these may be signs of too much potassium. [uniprix.com]

    […] increased hair growth acne (pimples), oily skin mild nausea (upset stomach) vomiting (throwing up) diarrhea (loose bowel movements) leg cramps tenderness or swelling of the gums (Carefully brush your child's gums or use a cool teething ring. [childrensmn.org]

Jaw & Teeth

  • Gingival Hypertrophy

    Other adverse effects: digestive disorders, hepatotoxicity (transient), hirsutism / hypertrichosis, angioedema, gingival hypertrophy, tremor, headache, paresthesia, myalgia, asthenia and hyperlipidemia. [tellmegen.com]

    […] fibrous tissue is normally observed, which is comparable with the histology of fibroadenomas that may reach a large size and be non-reversible, depending on the degree of fibrosis. 2 This histological profile is similar to that of cyclosporine A-induced gingival [revistanefrologia.com]

    These findings may precede kidney functions alterations.13,14 Therefore, the safest method to evaluate renal risk is histological analysis.2 Other side effects are arterial hypertension, hyperlipidemia, hypertrichosis, gingival hypertrophy and hyperuricemia [bjn.org.br]

    Other neurologic side effects include tremor, asthenia, and fatigue. 91 Psychiatric side effects have also been reported. 8 Patients with a history of seizures should be made aware that CSA can lower the seizure threshold. 8 Gingival hypertrophy, commonly [aad.org]

Cardiovascular

  • Hypertension

    (DBP>100mgHg) Treat with anti-hypertensive (check for interactions) or reduce dose Cyclosporin may give rise to a number of other side-effects which, if distressing to the patient, may require dose reduction or discontinuation. [nhsgrampian.org]

    […] and rarely severe hypertension may occur; incidence decreases over time; antihypertensive therapy may be required in recipients of kidney, liver, and heart allografts treated with cyclosporine; potassium-sparing diuretics should not be used to treat [reference.medscape.com]

    Hypertension Hypertension is another common side effect of CSA therapy that often resolves in patients treated with short courses of CSA. [aad.org]

    It may be accompanied by hypertension, hyperuricemia, hyperkalemia, hypomagnesemia. [tellmegen.com]

Musculoskeletal

  • Muscle Spasm

    spasms or weakness, fast or irregular heartbeat, muscle spasms, confusion, tingling in the hands or feet, problems in hearing, fatigue. [ibdcrohns.about.com]

    spasms (tetany) or twitching nausea and vomiting nervousness painful or difficult urination pounding in the ears shakiness in the legs, arms, hands, or feet shortness of breath skin rash slow or fast heartbeat sore throat sores, ulcers, or white spots [mayoclinic.org]

    However, listed below are some symptoms, if any of these symptoms occur, the patient needs to get medical intervention – o Severe leg pain o tingling skin/ Numb o irregular/ Slow heartbeat o Muscle spasms /weakness o Easy bleeding/bruising o Signs of [portea.com]

    Tell your doctor immediately if any of these symptoms of infection occur: fever, sore throat, flu -like symptoms, painful urination.Tell your doctor right away if you have any serious side effects, including: muscle spasms / weakness, fast/irregular heartbeat [medicinenet.com]

  • Arthralgia

    anemia, carcinoma, leukopenia, lymphadenopathy Hepatic: Hyperbilirubinemia Infection: Abscess (including renal), bacterial infection, candidiasis, fungal infection, herpes simplex infection, herpes zoster, viral infection Neuromuscular & skeletal: Arthralgia [drugs.com]

    […] moniliasis, tonsillitis, viral infection Hematologic: anemia, epistaxis, leukopenia, lymphadenopathy Liver and Biliary System: bilirubinemia Metabolic and Nutritional: diabetes mellitus, hyperkalemia, hyperuricemia, hypoglycemia Musculoskeletal System: arthralgia [web.archive.org]

Skin

  • Hirsutism

    Other adverse effects: digestive disorders, hepatotoxicity (transient), hirsutism / hypertrichosis, angioedema, gingival hypertrophy, tremor, headache, paresthesia, myalgia, asthenia and hyperlipidemia. [tellmegen.com]

    […] anemia, leukopenia, thrombocytopenia Metabolic: hyperglycemia, hypomagnesemia, hyperuricemia, hyperkalemia, metabolic acidosis Musculoskeletal: muscle and joint pain Respiratory: cough, dyspnea, Pneumocystis jiroveci pneumonia, bronchospasm Skin: acne, hirsutism [medical-dictionary.thefreedictionary.com]

    Common side effects of cyclosporine include headache, dizziness, paresthesias, neuropathy, tremor, hypertension, hyperlipidemia, nephropathy, acne, hirsutism and gum hyperplasia. [livertox.nih.gov]

    We did not observe hypertension or hirsutism in this cohort in the prescribed doses. Discussion The responses to cyclosporin in chronic ITP were observed from 40–55% in published studies of patients with small numbers 2–6. [haematologica.org]

    Some signs or symptoms of cyclosporin toxicity are: kidney damage high blood pressure tremors bleeding, swelling, overgrowth of gums hirsutism hyperlipidaemia Peak concentrations of samples collected 2 hours post dose are sometimes tested in transplant [labtestsonline.org.au]

  • Hypertrichosis

    […] component of all immunosuppressive protocols to control transplant rejection for solid organ graft recipients Nephrotoxicity is major concern (Clin J Am Soc Nephrol 2009;4:481) Nephrotoxic, hepatotoxic and neurotoxic Also causes gingival hyperplasia, hypertrichosis [pathologyoutlines.com]

    Hypertrichosis, gingival hyperplasia, and neurological and gastrointestinal effects are the most common adverse events in cyclosporin recipients, but are usually mild to moderate and resolve on dosage reduction. [ncbi.nlm.nih.gov]

    Other adverse effects: digestive disorders, hepatotoxicity (transient), hirsutism / hypertrichosis, angioedema, gingival hypertrophy, tremor, headache, paresthesia, myalgia, asthenia and hyperlipidemia. [tellmegen.com]

    As for the side effects, 73% (n=24) presented mild to moderate gingival hyperplasia and 79% (n=26) mild to moderate hypertrichosis. [bjn.org.br]

  • Eczema

    More Find an Article popular topics advocacy allergies alternative treatment ask a doctor atopic-dermatitis biologics burden of disease community comorbidities Dupixent eczema eczema awareness month eczema expo eczema warrior eczema warriors inflammation [nationaleczema.org]

    Types & treatments Childhood eczema Adult eczema Insider secrets Types of hair loss Treatment for hair loss Causes of hair loss Hair care matters Insider secrets What is psoriasis Diagnosis & treatment Skin, hair & nail care Triggers Insider secrets What [aad.org]

    In psoriasis and eczema cyclosporin is not used continuously for longer than 2 years to prevent permanent effects on kidney function and blood pressure. [dermcoll.edu.au]

    Common skin conditions that ciclosporin is used to treat are atopic eczema / dermatitis and psoriasis. [dermnetnz.org]

    D004485 HP:0000964 Eczema 3 ClinicalTrials Glomerulosclerosis, Focal Segmental D005923 EFO:0004236 focal segmental glomerulosclerosis 3 ClinicalTrials Leukemia, Prolymphocytic, T-Cell D015461 EFO:1000560 T-Cell Prolymphocytic Leukemia 2 ClinicalTrials [ebi.ac.uk]

  • Pruritus

    […] scar, eyelid pruritus, iridocyclitis. [santen.com]

    […] efficacy not established in children 1 Geriatric Use No substantial differences in safety and efficacy relative to younger adults. 1 Common Adverse Effects Ocular burning, conjunctival hyperemia, discharge, epiphora, ocular pain, foreign body sensation, pruritus [drugs.com]

    Other reactions reported in 1% to 5% of patients included conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, and visual disturbance (most often blurring). 6.2 Post-marketing Experience The following adverse [dailymed.nlm.nih.gov]

  • Erythema

    Clinical improvement was defined as the absence of reported symptoms, lack of progression and reduction in erythema and follicular hyperkeratosis found in SIAscopic images. [ncbi.nlm.nih.gov]

    Common Instillation site irritation, instillation site erythema, instillation site lacrimation. [santen.com]

    […] glomerulosclerosis with 2.5-5mg/day of ramipril being administered, and proteinuria decreased to DISCUSSION Cyclosporine is occasionally associated with uni- or bilateral breast growth in women, accompanied by variable local inflammatory signs, with significant erythema [revistanefrologia.com]

    DISCUSSION Circinate pustular psoriasis or pustular ring is a localized form of pustular psoriasis manifested by outbreaks of annular lesions, with erythema and pustules on the periphery, generally located on the trunk and roots of members with no systemic [scielo.br]

    J Am Acad Dermatol. 1993; 28: 134–135 Abstract | Full Text PDF | PubMed | Scopus (17) | Google ScholarSee all References and bullous erythema multiforme.65x65Wilkel, CS and McDonald, CJ. Cyclosporine therapy for bullous erythema multiforme [letter]. [mayoclinicproceedings.org]

Urogenital

  • Kidney Failure

    Problems with kidney function, including kidney failure, and hypertension can occur in cases where the drug is used for over one year. [aocd.org]

    Avoid using cyclosporine for more than 2 years, as this increases the chance of kidney failure. Biologic medications are much safer options in patients with severe disease necessitating systemic treatment. [the-dermatologist.com]

    Cyclosporine can cause serious side effects, including kidney failure or life-threatening infection. While using cyclosporine, you will need frequent blood tests to be sure cyclosporine is not causing harmful effects. [drugs.com]

  • Hot Flushes

    Coadministration of cyclosporine and aliskiren in these subjects also resulted in an increase in the number and/or intensity of adverse events, mainly headache, hot flush, nausea, vomiting, and somnolence. [dailymed.nlm.nih.gov]

    Your pharmacist may be able to advise you on managing side effects. acne or oily skin constipation decreased appetite diarrhea fatigue headache, including migraine hot flushes increase in hair growth leg cramps nausea night sweats trembling hands (tremor [uniprix.com]

    The vascular disorders included events of hot flushes and orthostatic hypotension. [doi.org]

  • Amenorrhea

    Besides weight loss and disturbances in body image, the patient developed alopecia, bradycardia, and persistent secondary amenorrhea. [ncbi.nlm.nih.gov]

  • Secondary Amenorrhea

    Besides weight loss and disturbances in body image, the patient developed alopecia, bradycardia, and persistent secondary amenorrhea. [ncbi.nlm.nih.gov]

Neurologic

  • Headache

    […] hair excessive, chronic diarrhea, tingling of tongue, finger tips and toes) Burden Not at all hard to take Dosage: 150 mg Daily Advice & Tips: When I was preparing my body for my transplant, I was taking a large dose of Neoral that gave me migraine headaches [patientslikeme.com]

    Headache This medication may cause headaches or migraines. Headache can also be a sign of elevated blood pressure, so this side effect should be reported to your provider for further evaluation. [oncolink.org]

    Call your doctor right away or go to the Emergency Department if your see any of these side effects: Fever, chills Cough or sore throat Blood in urine, difficulty urinating, or pain with urination Severe headache Seizures Confusion Shortness of breath [nephcure.org]

  • Paresthesia

    Other adverse effects: digestive disorders, hepatotoxicity (transient), hirsutism / hypertrichosis, angioedema, gingival hypertrophy, tremor, headache, paresthesia, myalgia, asthenia and hyperlipidemia. [tellmegen.com]

    Common side effects of cyclosporine include headache, dizziness, paresthesias, neuropathy, tremor, hypertension, hyperlipidemia, nephropathy, acne, hirsutism and gum hyperplasia. [livertox.nih.gov]

    […] with antilymphocyte globulin and methylprednisone for psoriasis Adverse effects Nephrotoxicity, HTN, neurotoxicity–eg, tremor, seizures, encephalopathy, headache, coma, hyperlipidemia, hyperkalemia, hypomagnesemia, HTN, anemia, anaphylaxis, nausea, paresthesias [medical-dictionary.thefreedictionary.com]

    Adverse reactions CNS: tremor, headache, seizures, confusion, paresthesia. CV: hypertension, flushing. EENT: sinusitis. GI: gum hyperplasia, oral candidiasis, nausea, vomiting, diarrhea, abdominal discomfort. GU: nephrotoxicity. [glowm.com]

    These include paresthesias, which were noted in four study patients, and seizures, which occurred in one patient. [doi.org]

Workup

Serum

  • Creatinine Increased

    Adverse Effects and their Management Serum creatinine increases >30% of baseline value Reduce dose by 25% Serum creatinine increases >50% of baseline value Reduce dose by 50% If serum creatinine dose not decrease within 1 month Stop drug and contact rheumatologist [nhsgrampian.org]

    There was a slight increase in the mean serum creatinine during the study, but there was no significant difference between treatment groups (Fig. 3). [academic.oup.com]

    Serum creatinine improved in all but one patient after discontinuation of cyclosporine. The “maximal creatinine increase” appears to be a factor in predicting cyclosporine nephropathy. [web.archive.org]

  • Eosinophils Increased

    However, abnormal CD3-CD4+ T cell clones remained even when the eosinophil count recovered to normal levels. An elevated IL-8 level was observed only when eosinophils increased. [ncbi.nlm.nih.gov]

Treatment

METHODS: We retrospectively evaluated C2 levels in 38 patients (17 males, 5.2 ± 2.9 years old) with SDNS at treatment initiation, at 6, 12 and 18 months during treatment, and at the time of kidney biopsy, 2-year after treatment initiation. [ncbi.nlm.nih.gov]

Prognosis

Her clinical features were compatible with TAFRO syndrome proposed as a variant of multicentric Castleman's disease, that is occasionally associated with poor prognosis. Treatment with corticosteroid improved her symptoms partially. [ncbi.nlm.nih.gov]

(B) Mean mRNA expression of oxidative phosphorylation proteins in diffuse large B-cell lymphoma patients with the worst prognosis vs. those with the best prognosis. [doi.org]

Etiology

Lichen striatus is an acquired, benign, linear inflammatory dermatosis characterized by a sudden skin eruption along Blaschko's lines that usually is not associated with specific etiologic agents. [ncbi.nlm.nih.gov]

Moritz, Neutropenia in dogs: etiology and prognostic factors, Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, 44, 5, (307), (2016). [doi.org]

Epidemiology

The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007; 5 : 93–107. 2. Hossain P, Konstantopoulos A. Blepharitis: remains a diagnostic enigma. [nature.com]

Pars planitis: Epidemiology, clinical characteristics, management and visual prognosis. Vol. 10, Journal of Ophthalmic and Vision Research. 2015. p. 469–80. ↑ Nussenblatt RB, Palestine AG, Chan CC, Breen L, Caruso R. [eyewiki.aao.org]

Epidemiology In published studies, the incidence of cancer in renal transplant recipients ranges from 2.3–31% [ 3 ], although this estimate is limited by the focus of individual studies on specific populations and a lack of long-term follow-up, thus potentially [doi.org]

Although other tumors (12 skin cancers, 24 solid tumors of diverse types, and 1 multiple myeloma) were also reported in this survey, epidemiologic analyses did not support a relationship to cyclosporine other than for malignant lymphomas. [web.archive.org]

Pathophysiology

Nussenblatt and his collaborators delved into the most significant adverse effect of CsA, renal toxicity, and helped elucidate the pathophysiology of renal injury. [ncbi.nlm.nih.gov]

Prevention

World English Dictionary ciclosporin or cyclosporin (ˌsaɪkləʊˈspɔːrɪn) — n a drug extracted from a fungus and used after organ transplantation to suppress the body's immune mechanisms, and so prevent rejection of an organ cyclosporin or cyclosporin — [web.archive.org]

Dec 8, 2016 (Started Jun 01, 2000) Effectiveness Major (for Prevent organ rejection) Burden Not at all hard to take Dosage: 175 mg/kg/day Daily Side effects: depressed mood 0 helpful marks Mar 4, 2012 (Started Mar 06, 2002) Effectiveness Slight (for Prevent [patientslikeme.com]

[…] cyclosporin (also cyclosporin A, cyclosporine ) noun mass noun Medicine A drug with immunosuppressive properties used to prevent the rejection of grafts and transplants. A cyclic peptide, it is obtained from a fungus. [en.oxforddictionaries.com]

Additionally, the cyclosporins are researched for their ability to prevent damage to normal functioning cells in autoimmune disorders. Cyclosporin A is over 99% pure and soluble in DMSO and ethyl alcohol. [goldbio.com]

Cyclosporine works by suppressing the immune system to prevent the white blood cells from trying to get rid of the transplanted organ. Cyclosporine is a very strong medicine. [mayoclinic.org]

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