Vinblastine-induced posterior reversible encephalopathy syndrome

Abstract

Posterior reversible encephalopathy syndrome has recently been recognized as an entity characterized by central neurological and radiological manifestations. There are increasing reports of posterior reversible encephalopathy syndrome associated with the use of chemotherapeutic agents. We herein present a case of posterior reversible encephalopathy syndrome occurring in a patient with Hodgkin's lymphoma after taking two courses of adriamycin, bleomycin, vinblastine, dacarbazine chemotherapy. A prompt recognition of posterior reversible encephalopathy syndrome associated with vinblastine and discontinuation of this drug is paramount to prevent severe neurological damage.

Etiologies, Cerebral Vasomotion, and Endothelial Dysfunction in the Pathophysiology of Posterior Reversible Encephalopathy Syndrome in Pediatric Patients

“…7,10, 20,34,47,50,54,69,70,116,[165][166][167][186][187][188][189] The impressive, varied, and myriad conditions and diseases in patients developing PRES have both enhanced and complicated our theories on the pathogenesis of the condition. In general, the most common precipitants giving rise to PRES in the adult and pediatric populations include hypertension, renal disease, solid organ and hematologic malignancy, 9, 15,39,42,190 chemotherapy, [17][18][19][20][21][22][23][24][25][26] solid organ transplantation, 16,[35][36][37][191][192][193] and immunosuppressive therapy. 31,73,120,[194][195][196][197][198][199] Solid organ malignancies reported contemporaneously with the development of PRES include brainstem ependymoma, 200 hepatoblastoma, …”

“…[12][13][14] The etiologic factors giving rise to this syndrome are plethora, myriad, and legion. 7 Afflicted patients often have renal dysfunction or arterial hypertension and an underlying solid organ or hematologic malignancy, or have recently received a solid organ or hematopoietic stem cell transplantation (HSCT), 7,8,10,15,16 chemotherapy, [17][18][19][20][21][22][23][24][25][26] or immunosuppressive therapy. [27][28][29][30] In the pediatric population, renal disease, 31 hypertension, 32 hematologic disease, 22,33 malignancy, 34 chemotherapy, 32 and transplantation 16,32,[35][36][37] represent the most common precipitants of PRES.…”