title: The Use of Continuous Veno-Venous Hemodiafiltration in the Management of Ifosfamide-induced Encephalopathy: A Case Report.
abstract: Encephalopathy is a common side effect of ifosfamide, occurring in up to 30% of patients. Although self-resolving in most cases, death secondary to severe encephalopathy has been reported. Methylene blue and thiamine have been occasionally successful as treatment. We report a case of an 11-year-old girl with relapsed neuroblastoma who developed grade 4 ifosfamide-induced encephalopathy. She showed no initial response to methylene blue and thiamine. She remained neurologically impaired and continuous veno-venous hemodiafiltration was started, with rapid resolution of encephalopathy. This is the first report of continuous veno-venous hemodiafiltration use for suspected ifosfamide-induced encephalopathy in the pediatric population.
authors.affiliation: *Children's Center for Cancer and Blood Diseases, Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles †Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA.
authors.forename: Kee Kiat
authors.initials: KK
authors.lastname: Yeo
authors.forename: Josephine H
authors.initials: JH
authors.lastname: HaDuong
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced* / Q000628:therapy; D002648:Child; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects*; D008751:Methylene Blue / Q000627:therapeutic use; D009447:Neuroblastoma / Q000188:drug therapy*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008751:Methylene Blue; D007069:Ifosfamide