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Ouchane K, Bellefkih FZ, Benchakroun N, Bourhafour M, Chekrine T, Bouchbika Z, Jouhadi H, Tawfiq N, Sahraoui S. Reversible posterior leukoencephalopathy syndrome following carboplatin and paclitaxel in cervical cancer: Case report. SAGE Open Med Case Rep 2024; 12:2050313X241257444. [PMID: 38812836 PMCID: PMC11135113 DOI: 10.1177/2050313x241257444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
Posterior reversible leukoencephalopathy is a rare radio-clinical entity that has gained increasing recognition over the last two decades. It is associated with various etiologies: arterial hypertension, autoimmune diseases, chemotherapy, and immunosuppressive drugs. Several cases have already been reported following cancer therapy. Posterior reversible leukoencephalopathy is characterized by capital clinical signs (headache, seizures, confusional syndrome, and visual disorders) and radiological abnormalities (cerebral edema predominantly in the posterior regions). We report the case of a 38-year-old female patient diagnosed with posterior reversible leukoencephalopathy after receiving Carboplatin and Paclitaxel chemotherapy for recurrent cervical cancer, which was revealed by a generalized seizure. Brain magnetic resonance imaging showed T2 Flair hyper signals in the parieto-occipital regions. This complication is rare but is probably underdiagnosed due to a lack of awareness and limited hindsight. Rapid diagnosis is essential to prevent acute neurological complications, which can be life-threatening or functionally crippling regardless of neoplasia.
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Affiliation(s)
- Karima Ouchane
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Fatima Zahra Bellefkih
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Nadia Benchakroun
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Mouna Bourhafour
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Tarik Chekrine
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Zineb Bouchbika
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Hassan Jouhadi
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Nezha Tawfiq
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
| | - Souha Sahraoui
- Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
- Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco
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Birle V, Dongargaonkar P, Sharma S, Gaiwal A. Posterior reversible encephalopathy syndrome in pregnancy: A case series of 5 cases. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_30_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gil I, Serrazina F, Pinto M, Viana-Baptista M. Posterior reversible encephalopathy syndrome associated with the use of chemotherapeutic agents: a rare complication after treatment with vinorelbine. BMJ Case Rep 2020; 13:13/2/e229319. [PMID: 32066575 DOI: 10.1136/bcr-2019-229319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterised by a combination of headache, encephalopathy, seizures and visual disturbances, associated with high-intensity abnormalities on T2-weighted images affecting subcortical white and grey matter of the occipital and parietal lobes. Among other causes, PRES has been associated with the use of several medications including chemotherapeutic agents. Here we report a case of a 65-year-old patient with squamous cell carcinoma of the lung treated with cisplatin/vinorelbine. Following the second administration of vinorelbine, she was admitted to the hospital for a generalised seizure. Blood pressure was just slightly elevated and, except for drowsiness, she had a near-normal neurological examination. MRI corroborated the diagnosis. Vinorelbine-induced PRES has been reported only once in the literature, also in association with cisplatin. Our case underlines the role of vinorelbine and suggests that its association with cisplatin in this setting may enhance the risk of PRES.
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Affiliation(s)
- Ines Gil
- Neurorradiology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | - Filipa Serrazina
- Neurology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | - Miguel Pinto
- Neurology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
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Li X, Chai J, Wang Z, Lu L, Zhao Q, Zhou J, Ju F. Reversible posterior leukoencephalopathy syndrome induced by apatinib: a case report and literature review. Onco Targets Ther 2018; 11:4407-4411. [PMID: 30104882 PMCID: PMC6072830 DOI: 10.2147/ott.s166605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare clinical-radiologic syndrome. There are reports that RPLS may be associated with cancer therapy including some chemotherapy drugs and antiangiogenic drugs. This paper reported a case of RPLS induced by apatinib, a vascular endothelial growth factor receptor 2 (VEGFR-2) tyrosine kinase inhibitor. A 47-year-old cervical cancer patient was administered apatinib, and 3 months later, headache, dizziness, blurred vision, and hypertension appeared. She was diagnosed with RPLS by nuclear magnetic resonance imaging (MRI). After apatinib discontinuation and normotensive treatment, her symptoms completely reversed. Antiangiogenic drugs potentially damage the balance of the blood–brain barrier by directly injuring vascular endothelial cells, resulting in the occurrence of RPLS. This case is the first report of RPLS induced by apatinib.
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Affiliation(s)
- Xutong Li
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
| | - Jie Chai
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
| | - Zhi Wang
- Department of MRI, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China
| | - Lin Lu
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
| | - Qingye Zhao
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
| | - Jie Zhou
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
| | - Fang Ju
- Department of Oncology, Second Affiliated Hospital, Qingdao University, Qingdao, Shandong 266042, People's Republic of China,
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Schoucair R, Nicolas G, Ahdab R, Bejjani N, Abdalla EK. Posterior reversible encephalopathy syndrome (PRES) in mesenteric leiomyosarcoma: A case report. Int J Surg Case Rep 2018; 49:96-101. [PMID: 29980031 PMCID: PMC6031592 DOI: 10.1016/j.ijscr.2018.04.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by headache, confusion, visual loss and seizures. Many factors influence the appearance of this syndrome, predominantly eclampsia, certain medical treatments and malignant hypertension. Diagnosed by typical transient lesions on magnetic resonance imaging. CASE REPORT We present a case of mesenteric leiomyosarcoma in a 52 year old woman, who had severe headache, abdominal heaviness, and hypertension. Investigations revealed a mesenteric mass and a Posterior Reversible Encephalopathy Syndrome features on brain MRI, suggesting renin secretion by the tumor, causing the patient's symptoms. CONCLUSION Patient's symptoms disappeared after resection of the tumor, suggesting a renin production cessation.
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Affiliation(s)
- Ramy Schoucair
- Lebanese University, Beirut, Lebanon; LAUMRCH, Beirut, Lebanon
| | - Gregory Nicolas
- Lebanese University, Beirut, Lebanon; LAUMRCH, Beirut, Lebanon.
| | - Rechdi Ahdab
- Lebanese University, Beirut, Lebanon; LAUMRCH, Beirut, Lebanon
| | - Noha Bejjani
- Lebanese University, Beirut, Lebanon; LAUMRCH, Beirut, Lebanon
| | - Eddie K Abdalla
- Lebanese University, Beirut, Lebanon; LAUMRCH, Beirut, Lebanon
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Chemotherapy-associated Posterior Reversible Encephalopathy Syndrome: A Case Report and Review of the Literature. Neurologist 2017; 21:112-117. [PMID: 27801773 DOI: 10.1097/nrl.0000000000000105] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION There are increasing reports of posterior reversible encephalopathy syndrome (PRES) associated with the use of chemotherapeutic agents. Recognition of PRES is crucial given its reversibility with appropriate supportive management. We report a patient presenting with PRES after treatment with Rituximab, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone (R-CHOP) and intrathecal methotrexate. We also perform a systematic review of the literature on chemotherapy-associated PRES. CASE REPORT A 72-year-old man with recently diagnosed diffuse large B-cell lymphoma became unresponsive 4 days after initiation of R-CHOP and intrathecal methotrexate. Brain magnetic resonance imaging showed interval development of occipital and temporal fluid attenuation inversion recovery hyperintensities consistent with PRES. The patient's blood pressure was aggressively controlled and he received 5 days of high-dose methylprednisone. He subsequently regained consciousness and his mental status gradually improved. Repeat magnetic resonance imaging showed interval resolution of the bilateral fluid attenuation inversion recovery hyperintensities. REVIEW SUMMARY We performed a systematic review of the literature and included a total of 70 unique cases involving chemotherapy-associated PRES. Platinum-containing drugs, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone/R-CHOP regimens, and gemcitabine were the agents most commonly used in patients who developed suspected chemo-associated PRES. Median onset of symptoms occurred 8 days after chemotherapy. Hypertension was the most commonly reported risk factor associated with the development of chemotherapy-associated PRES. In most cases, PRES improved with supportive management alone within 2 weeks. CONCLUSIONS Chemotherapy-associated PRES is an increasingly encountered syndrome. Both neurologists and non-neurologists should be familiar with the most commonly implicated agents, symptoms, risk factors, and clinical course of chemotherapy-associated PRES, given its favorable prognosis with appropriate management.
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Cherniawsky H, Merchant N, Sawyer M, Ho M. A case report of posterior reversible encephalopathy syndrome in a patient receiving gemcitabine and cisplatin. Medicine (Baltimore) 2017; 96:e5850. [PMID: 28225482 PMCID: PMC5569414 DOI: 10.1097/md.0000000000005850] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Posterior reversible encephalopathy syndrome (PRES) is a subacute syndrome causing characteristic neurologic and radiologic findings. PRES is predominantly caused by malignant hypertension though it has been associated with immunosuppressive treatments such as chemotherapy. PATIENT CONCERNS We describe a case of a 58 year old female who developed fluctuant level of consciousness, agitation. DIAGNOSIS MRI findings were in keeping with posterior reversible encephalopathy syndrome following cycle 6 of palliative gemcitabine and cisplatin therapy for metastatic cholangiocarcinoma. INTERVENTIONS The patient was managed with magnesium supplementation for hypomagnesemia and amlodipine. OUTCOMES The patient's level of consciousness returned to normal though she had residual neurologic deficits impairing her ability to drive and impacting her balance. CONCLUSIONS Cisplatin is a documented causative agent of PRES though gemcitabine is rarely associated with the syndrome. Combination cisplatin and gemcitabine therapy causing radiologically proven PRES has been documented in only 3 previous case reports. Gemcitabine's poor blood-brain barrier penetration makes it an unlikely culprit of central nervous system (CNS) toxicities. Our case and previous reports suggest higher doses may contribute to CNS toxicities such as PRES. Additionally, an emerging trend of hypomagnesemia associated with PRES has been documented inside and outside the context of malignancy and suggests a possible target for treatment and prevention warranting further investigation.
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Affiliation(s)
- Hannah Cherniawsky
- Department of Internal Medicine, University of Alberta, Edmonton, Alberta
| | | | | | - Maria Ho
- Cross Cancer Institute, Edmonton, Alberta, Canada
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Xie C, Jones VT. Reversible posterior leukoencephalopathy syndrome following combinatorial cisplatin and pemetrexed therapy for lung cancer in a normotensive patient: A case report and literature review. Oncol Lett 2015; 11:1512-1516. [PMID: 26893771 DOI: 10.3892/ol.2015.4059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 09/24/2015] [Indexed: 11/05/2022] Open
Abstract
Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare neurological syndrome of the brain, causing symptoms such as headaches, seizures, altered mental status and visual disturbances. The condition is predominantly associated with hypertension, eclampsia, renal impairment, cytotoxic drugs, immunosuppressive agents and molecular targeted agents, but the precise underlying mechanism of RPLS is not fully understood. The present study describes the case of a 65-year-old female patient with stage IIA non-small cell lung cancer who received cisplatin/pemetrexed treatment at the Leo W. Jenkins Cancer Center. Following 3 cycles of this therapy, the patient was referred to the Emergency Department of Vidant Medical Center with an altered mental status, subsequently presenting with epileptic seizures, a fever and a headache. A neurological examination revealed generalized hyperreflexia and paraparesis, with extensor posturing of the bilateral lower extremities. The lumbar puncture and electroencephalography results were normal, but cranial computed tomography (CT) scans revealed attenuation abnormalities in the bilateral parietal region and the left occipital lobe, with suspected metastasis. Cranial T2-weighted magnetic resonance imaging (MRI) indicated bilateral regions of increased signal intensity in the occipital, temporal and periventricular white matter. The patient was treated with anticonvulsants, steroids and antihypertensive drugs, recovered gradually from the symptoms and regained full consciousness. However, the patient reported residual weakness, presenting with an Eastern Cooperative Oncology Group score of 3, reflective of an inability to independently perform daily activities and self-care. A brain MRI performed 10 days later demonstrated that the subcortical edema had partially subsided. The patient was discharged on day 15 post-admission. A follow-up cranial CT examination 1 month later indicated a partial resolution of the abnormalities. The present report reviews similar associated cases, and also discusses the clinical features and mechanisms underlying RPLS. Although it is typically reversible, RPLS is a serious and potentially life-threatening adverse condition if left untreated. Early recognition of this condition is crucial for the prompt control of the patient's blood pressure or withdrawal of cytotoxic drugs in order to reverse this syndrome.
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Affiliation(s)
- Changqing Xie
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Vidant Medical Center, Greenville, NC 27834, USA
| | - Vovanti T Jones
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Vidant Medical Center, Greenville, NC 27834, USA
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Singer S, Grommes C, Reiner AS, Rosenblum MK, DeAngelis LM. Posterior Reversible Encephalopathy Syndrome in Patients With Cancer. Oncologist 2015; 20:806-11. [PMID: 26032137 DOI: 10.1634/theoncologist.2014-0149] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Posterior reversible encephalopathy syndrome (PRES) is characterized by neurologic symptoms with typical lesions on neuroimaging and may be associated with chemotherapy and immunosuppressive agents used in patients with cancer. We described the spectrum of PRES at a major cancer center. METHODS We reviewed charts of adults with PRES between 2005 and 2011 at Memorial Sloan Kettering Cancer Center for clinical information and outcome. RESULTS We identified 21 women (68%) and 10 men (median cohort age: 58 years). Solid tumors (n = 22, 71%) were more common than hematologic (n = 8) or primary brain malignancies (n = 1). Prior brain irradiation (16%) and central nervous system metastases (10%) were uncommon. There were 55% who received chemotherapy or targeted therapy within the month preceding PRES, including 6 patients who received bevacizumab; PRES followed allogeneic stem cell transplantation in 5 (16%). Presenting symptoms included confusion (71%), seizure (58%), and headache (48%). Maximum systolic and diastolic blood pressures were similar among patients grouped by cancer type, chemotherapy or bevacizumab use, and atypical imaging. Moreover, 37% of patients with both magnetic resonance imaging (MRI) and computed tomography (CT) had normal CT concurrent with PRES on MRI, and 84% returned to neurologic baseline at a median of 7.5 days (range: 1-167 days) from onset. Successful anticonvulsant taper was achieved in 51%. Chemotherapy rechallenge was attempted in 41% without recurrent PRES. Autopsy revealed nonspecific changes isolated to radiographically affected areas in one of two patients. CONCLUSION Recent chemotherapy, particularly bevacizumab, is common in cancer patients with PRES. Clinical and radiographic presentations may vary; MRI appears more sensitive than CT. Anticonvulsant taper and chemotherapy rechallenge is often possible. IMPLICATIONS FOR PRACTICE Posterior reversible encephalopathy syndrome is characterized by neurologic symptoms with typical lesions on neuroimaging and may be associated with chemotherapy and immunosuppressive agents used in patients with cancer. Clinical and radiographic presentations are protean, and magnetic resonance imaging is more sensitive than computed tomography. Recovery is common, and many patients can be successfully rechallenged with the apparently offending chemotherapy agent or regimen.
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Affiliation(s)
- Samuel Singer
- Departments of Neurology, Epidemiology and Biostatistics, and Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Christian Grommes
- Departments of Neurology, Epidemiology and Biostatistics, and Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Anne S Reiner
- Departments of Neurology, Epidemiology and Biostatistics, and Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marc K Rosenblum
- Departments of Neurology, Epidemiology and Biostatistics, and Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lisa M DeAngelis
- Departments of Neurology, Epidemiology and Biostatistics, and Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Lawlor PG, Bush SH. Delirium in patients with cancer: assessment, impact, mechanisms and management. Nat Rev Clin Oncol 2014; 12:77-92. [DOI: 10.1038/nrclinonc.2014.147] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Reversible posterior leukoencephalopathy syndrome associated with concurrent bevacizumab, gemcitabine, and oxaliplatin for cholangiocarcinoma. J Gastrointest Cancer 2013; 43:505-7. [PMID: 21556724 DOI: 10.1007/s12029-011-9279-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare disorder characterized by altered mental status, seizure, hypertension, and symmetrical white matter edema (leukoencephalopathy) typically in the posterior cerebral hemispheres on brain imaging. It is often linked to certain medication use, in particular, chemotherapeutic agents. Here, we present a case of chemotherapy-related RPLS and review the current literature on this topic. CASE REPORT We report a case of RPLS associated with concurrent bevacizumab (Avastin), gemcitabine, and oxaliplatin use for unresectable intrahepatic cholangiocarcinoma. CONCLUSION This is the first reported case of RPLS associated with bevacizumab, gemcitabine, and oxaliplatin combination chemotherapy. Concurrent use of multiple agents could significantly increase the risk of RPLS, a potentially fatal disease. Our case suggests that gradual progression of hypertension and proteinuria may be early warning signs before the onset of RPLS that should alarm clinicians.
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Matsunaga M, Araki K, Miwa K, Sunakawa Y, Yamashita K, Narabayashi M, Noguchi T, Nagashima F, Sasaki Y. Reversible posterior leukoencephalopathy syndrome associated with mFOLFOX6 chemotherapy. Int Cancer Conf J 2012. [DOI: 10.1007/s13691-012-0033-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kamezaki M, Kakimoto T, Takeuchi T, Akuta K, Kasahara H, Yamamoto K, Ujiie H, Sugahara H, Nishinaka K, Udaka F, Sakoda H. Reversible posterior leukoencephalopathy syndrome of bilateral thalamus in acute lymphoblastic leukemia. Leuk Lymphoma 2012; 53:2083-4. [DOI: 10.3109/10428194.2012.673227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cioffi P, Laudadio L, Nuzzo A, Belfiglio M, Petrelli F, Grappasonni I. Gemcitabine-induced posterior reversible encephalopathy syndrome: A case report. J Oncol Pharm Pract 2011; 18:299-302. [DOI: 10.1177/1078155211424628] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gemcitabine is a commonly used chemotherapeutic agent for a variety of tumors. Although this nucleoside analog antineoplastic agent is similar in structure to cytarabine, central nervous system toxicities have rarely been attributed to gemcitabine. The posterior reversible encephalopathy syndrome (PRES) is a condition characterized by reversible neurological and radiological findings that has been associated with use of chemotherapeutic and more recently novel targeted therapies. We describe one case of a 41-year-old woman with PRES under treatment for leiomyosarcoma because of the probable association with gemcitabine. Our case, to our knowledge, represents the seventh published report of this particular toxicity. Naranjo algorithm, efficacious method for assessing the causality of adverse drug reactions (ADRs) from a case report, suggests a direct casual relationship. PRES is probably a rare complication of gemcitabine, but the oncologist should take it into careful consideration, because PRES is reversible with treatment of current hypertension or removal of the causative agent. However, failure to quickly recognize the syndrome and discontinue the offending agent may result in profound and permanent central nervous system dysfunction or death.
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Affiliation(s)
| | - Lucio Laudadio
- Oncology Department of Lanciano Hospital, Lanciano, Italy
| | - Antonio Nuzzo
- Oncology Department of Lanciano Hospital, Lanciano, Italy
| | | | - Fabio Petrelli
- School of Specialization in Hospital Pharmacy, University of Camerino, Italy
| | - Iolanda Grappasonni
- School of Specialization in Hospital Pharmacy, University of Camerino, Italy
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Zhong M, Li B, Li J. Acute Transverse Myelopathy Probably Related to Intravenous Gemcitabine Plus Cisplatin. Ann Pharmacother 2011; 45:544-5. [PMID: 21487077 DOI: 10.1345/aph.1p674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Meizuo Zhong
- Division of Oncology Xiangya Hospital Central South University Changsha, Hunan, China
| | - Bin Li
- Division of Oncology Xiangya Hospital
| | - Jing Li
- Division of Neurology Xiangya Hospital
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