Tremor induced by Calcineurin inhibitor immunosuppression: a single-centre observational study in kidney transplanted patients

Journal of Neurology
R ErroMichele Tinazzi

Abstract

Tremor is the most frequent and disabling neurological side effect under Calcineurin inhibitor-induced immunosuppression, but no studies have defined its phenomenology, severity, distribution, the impact on quality of life, as well as of other neurological symptoms associated. 126 consecutive kidney-transplanted patients, under treatment with Cyclosporin A, Tacrolimus and non-Calcineurin inhibitors, within therapeutic range, were enrolled. Participants underwent a deep neurological examination by two blinded to the treatment raters, and a blood sampling to assess plasmatic immunosuppressant level and nephrological function tests. Tremor and cerebellar signs were scored according to the Fahn-Tolosa-Marin and the SARA scale. Parkinsonism was excluded applying the UPDRS (part III). Tremor was more common and severe in the Tacrolimus group, similar to impairment in ADL. Regardless of treatment, tremor involved both upper and lower limbs and was activated by action, but in about 50% of cases presented in action and rest condition. Plasmatic level of Tacrolimus was higher in patients with tremor than in those without, while cholesterol was significantly lower. Cerebellar and neuropathic signs were overall mild and were not significan...Continue Reading

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Citations

Jul 3, 2019·International Journal of Molecular Sciences·Wei ZhangSatohiro Masuda
Jan 4, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Han WangJie Zhao
Aug 18, 2021·Movement Disorders Clinical Practice·Eoin MulroyKailash P Bhatia

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