D'Angelo Paolo, Farruggia Piero, Lo Bello Antonio, Trizzino Antonino, Tropia Serena, Caselli Désirée, Aricò Maurizio
Oncoematologia Pediatrica, Ospedale dei Bambini G. Di Cristina, Palermo, Italy.
J Pediatr Hematol Oncol. 2006 Mar;28(3):177-81. doi: 10.1097/01.mph.0000210406.82050.07.
Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare complication of cancer chemotherapy. We have recently observed two cases occurred simultaneously in children receiving different chemotherapy regimens, for hepatoblastoma and acute lymphoblastic leukaemia, respectively. Both children presented with altered mental status, severe visual disturbances, headache, seizures, backpain and hypertension. Magnetic resonance imaging showed cortical and subcortical lesions especially in the occipital and parietal regions, strongly consistent with RPLS. Both patients completely recovered from their neuropsychologic deficits in about ten days only with anticonvulsant and antihypertensive therapy, and chemotherapy regimen was promptly restarted according to the planned protocol, without any neuropsychological sequela. A mild left midriasis was the only neurologic defect that persisted in the patient with acute lymphoblastic leukemia.
可逆性后部白质脑病综合征（RPLS）是癌症化疗的一种罕见并发症。我们最近观察到两例分别接受不同化疗方案的儿童同时发生RPLS，他们分别患有肝母细胞瘤和急性淋巴细胞白血病。两名儿童均出现精神状态改变、严重视觉障碍、头痛、癫痫发作、背痛和高血压。磁共振成像显示皮质和皮质下病变，尤其是枕叶和顶叶区域，与RPLS高度相符。仅通过抗惊厥和抗高血压治疗，两名患者在大约十天内神经心理缺陷完全恢复，并且按照计划方案迅速重新开始化疗，没有任何神经心理后遗症。轻度左侧瞳孔中度散大是急性淋巴细胞白血病患者唯一持续存在的神经缺陷。
