title: Reversible posterior leukoencephalopathy syndrome in a child treated with bevacizumab.
abstract: Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor (VEGF). Hypertension is a well-recognized, common side effect of VEGF blocking agents. The reversible posterior leukoencephalopathy syndrome (RPLS) has been described as a rare but serious consequence of bevacizumab administration. We present a case of a 6-year-old child with refractory hepatoblastoma who developed hypertensive crisis, seizures and MRI changes consistent with RPLS while receiving bevacizumab with gemcitabine and oxaliplatin. Findings completely resolved without neurologic sequelae with stringent blood-pressure control. Better understanding of risk for RPLS, prompt recognition and aggressive management will be required as bevacizumab gains wider use in pediatrics.
authors.affiliation: Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York, USA.
authors.forename: Carolyn Fein
authors.initials: CF
authors.lastname: Levy
authors.forename: Khine Zin
authors.initials: KZ
authors.lastname: Oo
authors.forename: Fernando
authors.initials: F
authors.lastname: Fireman
authors.forename: Louisdon
authors.initials: L
authors.lastname: Pierre
authors.forename: Marita A
authors.initials: MA
authors.lastname: Bania
authors.forename: Swayamprabha
authors.initials: S
authors.lastname: Sadanandan
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Yamashiro
authors.forename: Julia L
authors.initials: JL
authors.lastname: Glade Bender
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001794:Blood Pressure / Q000187:drug effects; D002675:Child, Preschool; D017809:Fatal Outcome; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D054038:Posterior Leukoencephalopathy Syndrome / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab