Posterior Reversible Encephalopathy Syndrome (PRES) After Treatment With Oxaliplatin and 5-Fluorouracil

Truman, Nicholas; Nethercott, Daniel

doi:10.1016/j.clcc.2012.06.003

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…The current case supports the observation that bortezomib-induced PRES is more common in women, with four of the five current cases occurring in female patients. This is also consistent with cases reported for other molecular targeting agents 13 17. Our patient had a full neurological recovery with discontinuation of bortezomib.…”

Section: Discussionsupporting

confidence: 92%

Posterior reversible encephalopathy syndrome resulting from repeat bortezomib usage

Nixon

Parhar

2014

BMJ Case Reports

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Bortezomib is a chemotherapeutic agent that acts via proteasome inhibition resulting in cellular apoptosis and inhibition of angiogenesis. Although widely accepted as treatment of multiple myeloma and non-Hodgkin's lymphoma, it has also been shown to be efficacious in a variety of solid tumours such as pancreatic and colonic. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological syndrome characterised by vasogenic oedema involving the postero-occipital cortical and subcortical white matter resulting in visual disturbances, seizures and altered mental status. Although in most cases PRES is reversible with removal of the provoking condition or drug, if not appropriately recognised and treated it may lead to permanent and life-threatening sequelae such as intracerebral haemorrhage and ischaemic infarction. We report a case of PRES associated with bortezomib therapy and contrast it with four other previously reported cases. Recognition of this potentially severe neurological complication is important with the increasingly widespread use of bortezomib.

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Section: Discussionsupporting

confidence: 92%

Posterior reversible encephalopathy syndrome resulting from repeat bortezomib usage

Nixon

Parhar

2014

BMJ Case Reports

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“…The autoregulatory failure of the vessels leads to vasodilation of the vessels, ultimately causing increased capillary hydrostatic pressure with subsequent vasogenic oedema 8. Although subsequent resolution of clinical symptoms and radiological oedema is often observed with prompt treatment of hypertension in patients with PRES, other mechanisms seem to be involved in the pathophysiology of PRES as it can occur in normotensive patients as well 9. Another alternative theory that has also surfaced attributes the development of the syndrome to decreased blood flow and ischaemia leading to cytotoxic oedema 10.…”

Section: Discussionmentioning

confidence: 99%

Oxaliplatin-induced posterior reversible encephalopathy syndrome (PRES)

Janjua

Hassan²,

Afridi

et al. 2017

BMJ Case Reports

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Posterior reversible encephalopathy syndrome (PRES), first introduced in 1996, is a neurotoxic state characterised by seizures, headache, vision change, paresis, nausea and altered mental status. Risk factors include hypertension, eclampsia/pre-eclampsia, infection/sepsis and cancer chemotherapy. Although exposure to toxic agents is a common occurrence in patients who develop PRES, oxaliplatin has rarely been associated with it, with only 10 cases reported worldwide. We present the case of an oxaliplatin-induced PRES in a 23-year-old male patient who was started on oxaliplatin/capecitabine as adjuvant chemotherapy for anal canal adenocarcinoma. The patient developed symptoms of headache, slurred speech and left-sided facial weakness on the ninth day after the first dose of oxaliplatin that lasted for 6-8 hours. The patient experienced another episode next day with similar symptoms that lasted for 8 hours. Oxaliplatin was withheld and the patient was discharged on capecitabine only. The patient had no new episodes since discharge on follow-up.

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“…Regarding encephalopathy after FOLFOX chemotherapy, posterior reversible encephalopathy, Wernike's encephalopathy, and hyperammonemic encephalopathy have been reported [ 2 3 ]. With our patient, we could reach the conclusion of chemotherapy-induced hyperammonemic encephalopathy because the patient's brain images did not show abnormal findings, and there is no abnormal laboratory findings to indicate altered mentality except for markedly increased ammonia levels.…”

Section: Discussionmentioning

confidence: 99%

Acute hyperammonemic encephalopathy after 5-fluorouracil based chemotherapy

Hong

Moon

et al. 2016

Ann Surg Treat Res

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5-Fluorouracil (5-FU) based chemotherapy has been commonly used to treat metastatic or advanced colon cancer as an adjuvant chemotherapy. Although the side effects of 5-FU such as gastrointestinal problems and neutropenia and thrombocytopenia are common, not many cases of 5-FU related encephalopathy are reported. Hyperammonemic encephalopathy is a rare central nervous system toxicity following 5-FU chemotherapy manifesting as altered mental status with elevated ammonia levels with no radiologic abnormality. We report one case of 5-FU induced hyperammonemic encephalopathy occurring after Folfox4 (oxaliplatin, folinic acid and 5-fluorouracil) chemotherapy in a colon cancer patient who presented with confused mental status soon after the chemotherapy and review the 5-FU related encephalopathy.

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Posterior Reversible Encephalopathy Syndrome (PRES) After Treatment With Oxaliplatin and 5-Fluorouracil

Cited by 13 publications

References 22 publications

Posterior reversible encephalopathy syndrome resulting from repeat bortezomib usage

Posterior reversible encephalopathy syndrome resulting from repeat bortezomib usage

Oxaliplatin-induced posterior reversible encephalopathy syndrome (PRES)

Acute hyperammonemic encephalopathy after 5-fluorouracil based chemotherapy

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