CASE REPORT

Tacrolimus-related nocturnal myoclonus of the lower limbs in elderly patients with rheumatoid arthritis

Authors

Takanori Azuma^1,2,3, Minoru Oishi⁴, Masami Takei³ and Shigemasa Sawada^2,3

1. Department of Rheumatology, Saitama Hospital, Kawagoe, Japan
2. Internal Medicine, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
3. Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
4. Department of Neurology, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
5. 1-9-3-907 Nishikosenbamachi Kawagoe 350-0035, Japan

Received:

02 November 2006

Accepted:

15 January 2007

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Abstract

Tacrolimus is an effective and well-tolerated treatment for rheumatoid arthritis (RA). We report three cases of strictly sleep-associated myoclonus in RA patients treated with tacrolimus. Although the high-dosage administration of tacrolimus in transplantation is known to cause diverse neurotoxic adverse effects, including myoclonus, no previous cases of myoclonus in RA, especially in association with sleep, have been reported. We suggest that this is not a rare adverse effect, particularly in elderly RA patients.

Key words

Myoclonus - Neurotoxicity - Nocturnal - Rheumatoid arthritis - Tacrolimus