Bortezomib-induced posterior reversible encephalopathy syndrome: a case report

Abstract

Posterior reversible encephalopathy syndrome (PRES) is an uncommon neurological syndrome due to autoregulation breakthrough with subsequent predominantly vasogenic oedemain associated with several clinical conditions. It is being increasingly reported in antineoplastic-treated patients. Here we report the case of a 72-year-old man who developed PRES during the second cycle of bortezomib treatment for multiple myeloma. Unlike usual PRES cases, only moderate hypertension was present at symptom onset, supporting the hypothesis that alterations of the vascular endothelium and blood-brain-barrier are the principal pathophysiological mechanisms involved in bortezomib-induced PRES. Prompt recognition of this potentially serious neurological adverse event is paramount to prevent mortality and long-term sequelae.

Advancing the care of patients with cerebrovascular disease: editorial

“…As an adjunct to active research, case reports provide valuable anecdotal evidence of the variable presentation and management techniques of disease. Candelaresi et al [7] presented a well written report of a patient who developed posterior reversible encephalopathy syndrome attributable to the administration of the myeloma protease inhibitor bortezomib. The case details the clinical course and association with drug and discusses potential mechanisms [5] .…”