Cysteamine toxicity presenting with acute encephalopathy and spastic tetraparesis.

Pract Neurol

Wessex Neurological Centre, Southampton General Hospital, Tremona Road, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Published: November 2024


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Article Abstract

Cystinosis is a lysosomal storage disorder usually presenting with renal disease in infancy. As soon as the diagnosis is made, cysteamine (a cystine-depleting medication), is started, significantly improving life expectancy. We describe a young woman taking lifelong cysteamine for nephropathic cystinosis, who became acutely encephalopathic with a spastic tetraparesis secondary to cysteamine toxicity, which was potentially worsened by copper deficiency. On replacing copper and reducing the dose of cysteamine, she made a full neurological recovery. We discuss the case, and review cystinosis and what is known about cysteamine toxicity.

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http://dx.doi.org/10.1136/pn-2024-004172DOI Listing

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