Gemcitabine Monotherapy Associated with Posterior Reversible Encephalopathy Syndrome

Abstract

Posterior reversible encephalopathy syndrome is a clinicoradiologic entity that may present with headaches, altered mental status, seizures and visual loss as well as specific neuroimaging findings. We report a case of a 74-year-old woman receiving adjuvant gemcitabine chemotherapy as monotherapy for a stage IIa pancreatic adenocarcinoma, who developed posterior reversible encephalopathy syndrome.

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients

“…Other possible etiologies are eclampsia, 4-7 transplantation, 8 neoplasia and chemotherapy treatment, 9 systemic infections, 10 renal disease acute or chronic. 11,12 …”

PRES with asymptomatic spinal cord involvement. Is this scenario more common than we know?

“…1 Many factors can act as triggers of this syndrome; the most common factors are the acute elevation of blood pressure, such as during eclampsia, abnormal renal function and immunosuppressive therapy. 1,2 Other possible etiologies already described are autoimmune diseases (lupus) 3 , allogeneic bone marrow and solid organ transplantation 4,5 , neoplasia and chemotherapy treatment 6,7 , systemic infections, sepsis 8,9 and exposure to venom. [3][4][5][6][7][8][9][10] The pathophysiology of PRES remains unclear; however, it appears to be related to cerebral autoregulation failure.…”

“…1,2 Other possible etiologies already described are autoimmune diseases (lupus) 3 , allogeneic bone marrow and solid organ transplantation 4,5 , neoplasia and chemotherapy treatment 6,7 , systemic infections, sepsis 8,9 and exposure to venom. [3][4][5][6][7][8][9][10] The pathophysiology of PRES remains unclear; however, it appears to be related to cerebral autoregulation failure. The cerebral autoregulation maintains the cerebral blood flow constant over a range of mean blood pressures by arteriolar vasoconstriction and vasodilatation.…”

Posterior Reversible Encephalopathy Syndrome Following a Scorpion Sting

“…Numerous factors have been seen in the setting of PRES or in association with PRES including: acute elevation of blood pressure, abnormal renal function, and immunosuppressive therapy . Other possible etiologies are eclampsia, transplantation, neoplasia and chemotherapy treatment, systemic infections, renal disease acute, or chronic…”