title: Posterior reversible encephalopathy syndrome in leukemic children: a sensitive issue.
abstract: Posterior reversible encephalopathy syndrome (PRES) is an acute central nervous system disorder characterized by reversible brain vasogenic edema. We report here a new case of a nine-year-old boy with B-cell acute lymphoblastic leukemia (B-ALL) who developed PRES secondary to induction chemotherapy including dexamethasone (dexamethasone®), vincristine (oncovin(®)), daunorubicin (adriblastine(®)) and intrathecal injection. Cerebral magnetic resonance imaging (MRI) showed high signal intensity on T2 at cortical and sub cortical region of parieto-frontal and parieto-occipital lobes. The patient was put under sodium valproate (depakine(®)) and we decided to continue dexamethasone (dexamethasone(®)) and daunorubicin (adriblastine(®)) injection. The MRI, after four weeks, was normal. So, we resumed vincristine (oncovin(®)) and we started L-asparaginase injections. Then, the outcome was favorable. The treatment of PRES is based on the withdrawal of the triggering factor to avoid the risk of irreversible lesions. But, due to the severity of leukemia the discontinuation of chemotherapy is difficult because of the risk of disease progression.
authors.affiliation: Department of Hematology Hedi Chaker Hospital Sfax 3029 Tunisia. walabenkridis@yahoo.fr.
authors.forename: Wala Ben
authors.initials: WB
authors.lastname: Kridis
authors.forename: Moez
authors.initials: M
authors.lastname: Mdhaffer
authors.forename: Yosr
authors.initials: Y
authors.lastname: Hentati
authors.forename: Fatma
authors.initials: F
authors.lastname: Kammoun
authors.forename: Abir
authors.initials: A
authors.lastname: Milad
authors.forename: Sondes
authors.initials: S
authors.lastname: Haddar
authors.forename: Khaireddine Ben
authors.initials: KB
authors.lastname: Mahfoudh
authors.forename: Chahinez
authors.initials: C
authors.lastname: Triki
authors.forename: Moez
authors.initials: M
authors.lastname: Elloumi
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use; D001929:Brain Edema; D002648:Child; D003630:Daunorubicin / Q000009:adverse effects / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D004569:Electroencephalography; D023261:Glasgow Outcome Scale; D006801:Humans; D015448:Leukemia, B-Cell / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced*; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine; D003907:Dexamethasone; D003630:Daunorubicin