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Year : 2014  |  Volume : 10  |  Issue : 2  |  Page : 393-396

Recurrent posterior reversible encephalopathy syndrome after chemotherapy in hematologic malignancy-posterior reversible encephalopathy syndrome can strike twice!!!

1 Department of Radiation Oncology, Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
2 Department of Radio Diagnosis, Institute Rotary Cancer Hospital, AIIMS, New Delhi, India

Correspondence Address:
Soumyajit Roy
Department of Radiation Oncology, Institute Rotary Cancer Hospital, AIIMS, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.136668

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Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiological syndrome characterized by seizures, altered level of consciousness, visual disturbance, and hyperintense lesions on magnetic resonance imaging most commonly in the posterior regions. PRES is typically associated with a number of complex clinical conditions including: Preeclampsia/eclampsia, allogeneic bone marrow transplantation, solid organ transplantation, autoimmune diseases, and high-dose anti-neoplastic therapy. We herein describe a case of recurrent PRES in a 29-year-old lady of refractory anaplastic large-cell lymphoma who was on second-line chemotherapy with Ifosfamide-Carboplatin-etoposide regimen. We have also tried to illustrate the pathogenesis, radiological features, and management of PRES. Although reversible in most cases, PRES may be recurrent even in chemotherapy - induced cases and result in fatal outcomes despite appropriate intervention. This is the first - reported case of recurrent PRES with such a fatal outcome, as a complication of anti-neoplastic systemic therapy.

Abstract in Chinese

恶性血液病中的可逆性后部脑病综合征化疗后复发:可逆性脑病综合征两次打击!!! 摘要 可逆性后部脑病综合征(PRES)是一种神经影像学综合征,临床表现为癫痫发作,意识水平的改变,视力障碍,磁共振成像常见脑中后部区域的高信号病灶。PRES通常是与一些复杂的临床条件相关,包括:先兆子痫/子痫,异基因骨髓移植,器官移植,自身免疫性疾病,高剂量抗肿瘤治疗。本文报道一位29岁的女性患者,有复发的难治性间变性大细胞淋巴瘤,予卡铂-足叶乙甙-异环磷酰胺二线化疗方案。本文分析PRES的病理学发生机制,影像学特征,以及PRES的治疗方案。虽然在大多数情况下可恢复,PRES甚至可能在化疗后的病例中复发并导致致命的结果。本文既是第一次报告复发性PRES伴致命的结果,作为抗肿瘤的全身治疗的并发症。 关键词:卡铂,足叶乙甙,异环磷酰胺,后部可逆性脑病综合征,复发

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