Chemotherapy induced reversible posterior leukoencephalopathy syndrome.
The reversible posterior leukoencephalopathy syndrome (RPLES) is a condition characterised by reversible neurological and radiological findings that has been associated with use of immunosuppressive, chemotherapeutic and more recently novel targeted therapies. We describe the case of a 50-year-old woman with advanced non-small cell lung cancer who developed status epilepticus shortly after receiving cisplatin and gemcitabine chemotherapy. The clinical, radiological and EEG findings during and post event are presented and are in keeping with a diagnosis of RPLES. Early recognition of this rare syndrome, supportive management and withdrawal of the offending agent appear to result in a reversal of the manifestations described.
Connolly
Roisin M
RM
Academic Unit of Clinical & Molecular Oncology, Trinity College Dublin & St. James's Hospital, Dublin 8, Ireland. roisinconnolly@gmail.com
Doherty
Colin P
CP
Beddy
Peter
P
O'Byrne
Ken
K
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000175:diagnosis; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D012264:Ribonucleotide Reductases / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D003841:Deoxycytidine; D012264:Ribonucleotide Reductases; D002945:Cisplatin; D000093542:Gemcitabine