title: L-asparaginase-induced posterior reversible encephalopathy syndrome during acute lymphoblastic leukemia treatment in children.
abstract: L-asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. The purpose of this article is to present the first case-series of posterior reversible encephalopathy syndrome (PRES) associated with L-asparaginase treatment. We report 3 cases of children with acute lymphoblastic leukemia who developed seizures and altered sensorium after L-asparaginase therapy. MRI showed increased T(2) signal intensity predominant in the posterior regions of the brain suggestive of PRES. Two of our patients developed septic shock and deteriorated whereas one patient improved and recovered completely.
authors.affiliation: Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon. rh64@aub.edu.lb
authors.forename: R
authors.initials: R
authors.lastname: Hourani
authors.forename: M
authors.initials: M
authors.lastname: Abboud
authors.forename: M
authors.initials: M
authors.lastname: Hourani
authors.forename: H
authors.initials: H
authors.lastname: Khalifeh
authors.forename: S
authors.initials: S
authors.lastname: Muwakkit
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001215:Asparaginase / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced* / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012640:Seizures / Q000139:chemically induced; D012772:Shock, Septic / Q000139:chemically induced
chemical_list: D000970:Antineoplastic Agents; D001215:Asparaginase