Central Pontine Myelinolysis Associated with Cyclosporine in a Patient with NK Cell Leukaemia after Hematopoietic Stem Cell Transplantation

Central pontine myelinolysis (CPM) has been described as a rare complication of liver transplantation. Cases in allogeneic hematopoietic stem cell transplant are less reported. We present a patient with NK cell leukaemia who underwent allogeneic hematopoietic stem cell transplant and had progressive altered mental status and neurological deterioration. Clinical and radiological findings were consistent with CPM. The patient had hepatic impairment and was on cyclosporine at the time of diagnosis of CPM, both are common risk factors for development of CPM in the post-transplant setting. Patient was managed in the intensive care unit. A trial of corticosteroids was given and immunosuppressive agent was switched from cyclosporine to sirolimus. Patient regained full neurological function from this CPM episode.