Ciclosporin

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Leg bone pain syndrome: case report A 34-year-old woman developed leg bone pain syndrome during treatment with ciclosporin for ulcerative colitis. The pregnant woman was hospitalised and treated with IV ciclosporin 2 mg/kg [frequency and duration of treatment not stated]; her therapy was changed to oral ciclosporin [dosage not stated] when her symptoms improved. She reported severe nocturnal lower limb pain within 12 hours of initiation of the oral preparation. The symptoms remitted in the morning, but recurred 2 nights later and she subsequently experienced only occasional pain-free nights. Pain was most severe in her knees and milder in her feet and ankles; symptoms commenced with sensations of tingling and swelling in the early evening, and became progressively more painful throughout the night. Her symptoms worsened with walking and she became unable to stand due to the pain; towards morning, her pain decreased markedly. Treatment with dextropropoxyphene/paracetamol [acetaminophen] and diclofenac was unsuccessful. The woman’s trough ciclosporin concentrations were 120–180 ng/mL and an x-ray absorptiometry scan had been consistent with osteopenia 1 week earlier. Ciclosporininduced leg bone pain syndrome was considered. She started receiving nifedipine with significant improvement of her pain, and her symptoms subsequently resolved. She underwent colectomy about 1 month later. Ciclosporin and nifedipine were discontinued and her symptoms did not recur. Rahman AHA, et al. Leg bone pain syndrome in a patient with ulcerative colitis treated with cyclosporin. Irish Journal of Medical Science 176: 129-131, No. 2, Jun 801096028 2007 - Ireland

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Reactions 5 Jan 2008 No. 1183