Immunosuppressants — MCQs

A 29-year-old man with refractory ulcerative colitis has failed mesalamine, corticosteroids, and thiopurines. He requires hospitalization for severe bloody diarrhea (15 stools/day), abdominal pain, and fever. He is started on IV cyclosporine with improvement, then transitioned to oral cyclosporine. His gastroenterologist plans bridge therapy to infliximab. The patient develops a seizure on day 10 of cyclosporine therapy. His cyclosporine level is 320 ng/mL (target 200-400 ng/mL), magnesium is 1.2 mg/dL, cholesterol is 145 mg/dL. Evaluate the clinical presentation and synthesize the pathophysiology and management.