Unilateral mydriasis from ipratropium in transplant patients
Citation Manager Formats
Make Comment
See Comments
![Loading Loading](https://n.neurology.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif)
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Intracranial hemorrhage (ICH) is common in autopsy series of hematopoietic cell transplantation (HCT).1 ICH often presents with third nerve signs of transtentorial herniation. Unilateral pupillary dilatation from scopolamine, used as a transdermal patch for post-HCT nausea, can be a false indicator of ICH.2 I describe similar diagnostic confusion with ipratropium/albuterol (I/A) in four patients with HCT.
I studied four men, aged 22 to 64 years (median 41 years), who had undergone allogeneic HCT 1 to 6 months previously (table). All patients had multiple complications after transplant, including two patients with alveolar hemorrhage, atrial fibrillation, and renal failure requiring dialysis. Patient 1 had enterococcal meningitis, and Patient 4 had aspergillus pulmonary infection. All four patients had recent bacteremia, and all were thrombocytopenic with platelet counts of 27,000 to 94,000/μL (median 46,000/μL) on the day of the neurologic consultation.
- In this window
- In a new window
Table Transplant …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Association of Neurofilament Light With the Development and Severity of Parkinson Disease
Dr. Rodolfo Savica and Dr. Parichita Choudhury
► Watch
Related Articles
- No related articles found.
Topics Discussed
Alert Me
Recommended articles
-
Articles
Severe neurologic complications after hematopoietic stem cell transplantation in childrenM. Faraci, E. Lanino, G. Dini et al.Neurology, December 24, 2002 -
Resident & Fellow Section
Pearls & Oy-sters: Anisocoria Greater in the Dark: It's Not Just All About Horner PupilEmily Witsberger, Sasha A. Mansukhani, John J. Chen et al.Neurology, November 18, 2020 -
ARTICLES
Neurologic complications of autologous and allogeneic bone marrow transplantation in patients with leukemiaA comparative studyF. Graus, A. Saiz, J. Sierra et al.Neurology, April 01, 1996 -
Articles
Hematopoietic stem cell transplantation in patients with sporadic amyotrophic lateral sclerosisS. H. Appel, J. I. Engelhardt, J. S. Henkel et al.Neurology, October 20, 2008