초록
승모판막 폐쇄부전증으로 승모판막 치환술을 받은 45세 남자가 확장성 심근증으로 심장이식수술을 받았다. 환자는 수술전 면역억제를 위하여 cyclosporine 400 mg, Immuran 250 mg과 Solumedrol 500 mg을 투약하였 다 술후 cyclosporine을 2 mg/kg/day로 정주했는데 술후 8시간이 지나도 혼수상태가 지속되어 cyclosporine을 1 mg/kg/day로 감량하였다. 당시 혈장내 cyclosporine농도는 345$\mu\textrm{g}$/L, 크레아티닌 수치는 1.8 mg/dl였으며 마그 네슘 수치는 정상수준이 였다. 환자의 의식은 술후 31시간째 완전히 회복되었으나 술후 36시간경부터 전신근 력약화, 초조감, 환청 및 환각을 호소하였다. 신경증상들은 술후 4일째 정상으로 회복되었으며, 환자는 술후 28일째 퇴원하였고 12개월째 후유증은 보이지 않고 있다.
A 45-year-old man underwent heart transplantation due to dilated cardiomyopathy. Cyclosporine, 2 mg/kg per day, was intravenously givell postoperatively. As central neurotoxicity signs that were included pin-point pupil, no light reflex, coma, were presented at 8 postoperative hours, cyclosporine was decreased to 1 mg/kg er day. At that time the cyclosporine level was 345 $\mu\textrm{g}$/L, the serum creatinine level was 1.8mg/dl and the serum magnesium level was within normal limit. He awaked at 31 postoperative hours and all sign of cyclosporine-induced central neurotoxicity was resolved after postoperative days. He was discharged without sequale at postoperative day 28.
