Cyclophosphamide-induced posterior reversible encephalopathy syndrome (PRES): A case report

被引：18

作者：

Jayaweera J.L. ^{[1
]}

Withana M.R. ^{[1
,4
]}

Dalpatadu C.K.P. ^{[1
]}

Beligaswatta C.D. ^{[1
]}

Rajapakse T. ^{[2
]}

Jayasinghe S. ^{[3
]}

Chang T. ^{[3
]}

机构：

[1] University Medical Unit, National Hospital, Colombo

[2] Department of Radiology, Neuro-Trauma Centre, National Hospital, Colombo

[3] Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo

[4] Singheraja Garden ,8th Mile Post, Yattapatha-Mathugama

来源：

Journal of Medical Case Reports | / 8卷 / 1期

关键词：

Cyclophosphamide; Posterior reversible encephalopathy syndrome (PRES); Systemic lupus erythematosus;

D O I：

10.1186/1752-1947-8-442

中图分类号：

学科分类号：

摘要：

Introduction: Posterior reversible encephalopathy syndrome is a clinicoradiologic entity characterized by headache, seizures, decreased vision, impaired consciousness and white matter oedema in bilateral occipitoparietal regions. Hypertensive encephalopathy, eclampsia, immunosuppressive/cytotoxic drugs, organ transplantation, renal disease, autoimmune diseases and vasculitides are reported risk factors of posterior reversible encephalopathy syndrome. Reports of cyclophosphamide-induced posterior reversible encephalopathy syndrome are rare and occurred in a background of renal failure, fluid overload or active connective tissue disease. Case presentation: We report a case of posterior reversible encephalopathy syndrome developing as a direct consequence of intravenous cyclophosphamide therapy in a 33-year-old normotensive Sri Lankan woman with lupus nephritis but quiescent disease activity and normal renal function. Conclusions: This case report highlights the need for awareness and early recognition of this rare but serious adverse effect of cyclophosphamide that occurred in the absence of other known risk factors of posterior reversible encephalopathy syndrome and that early appropriate intervention leads to a good outcome.

引用

共 12 条

[1] Hinchey J., Chaves C., Appignani B., Breen J., Pao L., Wang A., A reversible posterior leukoencephalopathy syndrome, N Engl J Med, 334, 8, pp. 494-500, (1996)
[2] Min L., Zwerling J., Ocava L.C., Chen I.H., Putterman C., Reversible posterior leukoencephalopathy in connective tissue diseases, Semin Arthritis Rheum, 35, 6, pp. 388-395, (2006)
[3] Ishimori M.L., Pressman B.D., Wallace D.J., Weisman M.H., Posterior reversible encephalopathy syndrome: Another manifestation of CNS SLE?, Lupus, 16, (2007)
[4] Primavera A., Audenino D., Mavilio N., Cocito L., Reversible posterior leucoencephalopathy syndrome in systemic lupus and vasculitis, Ann Rheum Dis, 60, 5, pp. 534-537, (2001)
[5] Lee C.-H., Lee Y.M., Ahn S.H., Ryu D.W., Song J.H., Lee M.-S., Cyclophosphamideinduced posterior reversible encephalopathy syndrome in a patient with lupus nephritis, J Rheum Dis, 20, 2, pp. 103-107, (2013)
[6] Abenza-Abildua M.J., Fuentes B., Diaz D., Royo A., Olea T., Aguilar-Amat M.J., Diez-Tejedor E., Cyclophosphamide-induced reversible posterior leukoencephalopathy syndrome, BMJ Case Rep, (2009)
[7] Houssiau F.A., Vasconcelos C., D'Cruz D., The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide, Ann Rheum Dis, 69, (2010)
[8] Covarrubias D.J., Luetmer P.H., Campeau N.G., Posterior reversible encephalopathy syndrome: Prognostic utility of quantitative diffusionweighted MR images, AJNR Am J Neuroradiol, 23, 6, pp. 1038-1048, (2002)
[9] Gocmen R., Ozgen B., Oguz K.K., Widening the spectrum of PRES: Series from a tertiary care center, Eur J Radiol, 62, 3, pp. 454-459, (2007)
[10] Liu B., Zhang X., Zhang F.C., Yao Y., Zhou R.Z., Xin M.M., Wang L.Q., Posterior reversible encephalopathy syndrome could be an underestimated variant of "reversible neurological deficits" in Systemic Lupus Erythematosus, BMC Neurol, 12, (2012)

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