title: Bortezomib-induced posterior reversible encephalopathy syndrome: clinical and imaging features.
abstract: Posterior reversible encephalopathy syndrome (PRES) is a rare and potentially harmful complication in patients receiving targeted chemotherapy. We herein present a case of PRES that occurred after 33 days of high-dose bortezomib treatment and propose both overwhelmed cerebral autoregulation and toxin-mediated blood-brain barrier damage as the underlying mechanisms based on the imaging findings. A favorable recovery was observed two days after achieving stringent hypertension control and withholding bortezomib. Follow-up images obtained two weeks later unveiled a dramatic remission, with faint areas of subcortical hyperintensity in the bilateral parieto-occipital regions. With explicit clinical and imaging features, this case highlights the need for early recognition of PRES during the clinical course of bortezomib therapy.
authors.affiliation: Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan.
authors.forename: Chien-Hui
authors.initials: CH
authors.lastname: Ho
authors.forename: Chung-Ping
authors.initials: CP
authors.lastname: Lo
authors.forename: Min-Chien
authors.initials: MC
authors.lastname: Tu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced* / Q000175:diagnosis*; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects*; D013577:Syndrome
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib