Fatal outcome of posterior “reversible” encephalopathy syndrome in metastatic colorectal carcinoma after irinotecan and fluoropyrimidine chemotherapy regimen

World Journal of Surgical Oncology

Case Report

Ana Mišir Krpan¹  Natalija Dedić Plavetić¹  Vesna Bišof¹  Luka Simetić¹  Zoran Rakušić¹  David Ozretić² 

[1] Department of Oncology, University Hospital Center, Kišpatićeva 12, HR-10000, Zagreb, Croatia;Department of Radiology, University Hospital Center, Kišpatićeva 12, HR-10 000, Zagreb, Croatia;

关键词: Chemotherapy;    Fluoropyrimidine;    Fluorouracil;    Irinotecan;    Posterior reversible encephalopathy syndrome;   

DOI  :  10.1186/1477-7819-12-264

 received in 2014-06-18, accepted in 2014-08-06,  发布年份 2014

来源: Springer

【 摘 要 】

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, and visual disturbances. It can occur in many different clinical entities such as severe hypertension and pre-eclampsia, or due to cytotoxic or immunosuppressive therapies. The pathogenesis of PRES is unclear, with dysregulated cerebral auto-regulation and endothelial dysfunction as important mechanisms proposed. Endothelial dysfunction is important especially in cases associated with cytotoxic therapies. Herein, we describe a patient with PRES with fatal outcome, who presented 5 days after the infusion of cycle 1 of irinotecan hydrochloride, leucovorin calcium, and fluorouracil (FOLFIRI) regimen chemotherapy, without prior hypertension and other comorbidity, suggesting a link between PRES and FOLFIRI regimen. To our knowledge, this case report is the first describing PRES after FOLFIRI regimen, although others have described PRES after FOLFIRI with bevacizumab in colonic cancer patients.

【 授权许可】

CC BY   
© Dedić Plavetić et al.; licensee BioMed Central Ltd. 2014