Reversible posterior leukoencephalopathy syndrome in a child treated with bevacizumab.
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.
Levy
Carolyn Fein
CF
Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York, USA.
Oo
Khine Zin
KZ
Fireman
Fernando
F
Pierre
Louisdon
L
Bania
Marita A
MA
Sadanandan
Swayamprabha
S
Yamashiro
Darrell J
DJ
Glade Bender
Julia L
JL
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
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab