Tumor lysis syndrome as a contributory factor to the development of reversible posterior leukoencephalopathy.
BACKGROUND
Reversible posterior leukoencephalopathy syndrome (RPLS) is a recently described clinical and radiological entity comprising headache, seizures, altered level of consciousness and visual disturbances in association with transient posterior cerebral white-matter abnormalities.


METHODS
We report a young woman with Burkitt's lymphoma who developed RPLS after combined chemotherapy administered during the tumor lysis syndrome.


RESULTS
The symptoms in this patient fitted well with those of RPLS; they included abrupt alterations in mental status, seizures, headache, visual changes and characteristic neuroradiological findings. She was given further combination chemotherapy without any neurological complications, at which time she had already recovered from both RPLS and tumor lysis syndrome.


CONCLUSIONS
Although many etiological factors have been reported in the development of RPLS, the underlying mechanism is not yet well understood. With prompt and appropriate management, RPLS is usually reversible, and chemotherapy can be continued after complete recovery from RPLS. We suggest that tumor lysis syndrome should be considered as a contributory factor to the development of RPLS in patients for whom treatment with combined chemotherapy for hematological malignancies is planned.
Ozkan
A
A
Division of Hematology, Department of Internal Medicine, Uludag University Hospital, Uludag University School of Medicine, 16059 Bursa, Turkey. dratilla@uludag.edu.tr
Hakyemez
B
B
Ozkalemkas
F
F
Ali
R
R
Ozkocaman
V
V
Ozcelik
T
T
Taskapilioglu
O
O
Altundal
Y
Y
Tunali
A
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D019575:Blindness, Cortical / Q000209:etiology; D002051:Burkitt Lymphoma / Q000188:drug therapy; D003128:Coma / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000209:etiology; D013577:Syndrome; D015275:Tumor Lysis Syndrome / Q000150:complications*