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

Journal of Medical Case Reports

Thashi Chang¹  Saroj Jayasinghe¹  Thamara Rajapakse⁴  Chathurika D Beligaswatta³  Chamila KP Dalpatadu³  Milinda R Withana²  Jayamalee L Jayaweera³ 

[1] Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;8th Mile post, Singheraja Garden, Mathugama, Yattapatha, Sri Lanka;University Medical Unit, National Hospital, Colombo, Sri Lanka;Department of Radiology, Neuro-Trauma Centre, National Hospital, Colombo, Sri Lanka

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

Others  :  1180897
DOI  :  10.1186/1752-1947-8-442

 received in 2014-09-11, accepted in 2014-11-10,  发布年份 2014

【 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.

【 授权许可】

   
2014 Jayaweera et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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