Washington Hospital Center, Washington, DC 20010, USA.
Clin Colorectal Cancer. 2009 Jul;8(3):163-5. doi: 10.3816/CCC.2009.n.026.
Reversible posterior leukoencephalopathy (RPLS), also known as posterior reversible encephalopathy syndrome, is characterized by magnetic resonance imaging (MRI) findings of reversible vasogenic subcortical edema without infarction. The clinical presentation is usually nonspecific and typically involves global encephalopathy, seizures, headache, or visual symptoms. MRI of the brain is essential to the diagnosis of RPLS. Typical findings of RPLS include high-intensity signal on T2-weighted images predominantly in the posterior lobes of the brain that is caused by subcortical white matter vasogenic edema. Fluid-attenuated inversion recovery (FLAIR) sequences on MRI improve sensitivity and detect subtle peripheral lesions. This clinical radiographic syndrome has been described in a number of medical conditions, with hypertensive encephalopathy, eclampsia, and the use of immunosuppressant drugs (most notably calcineurin inhibitors) being the most common. It has occasionally been reported with cisplatin and rarely with carboplatin. Its occurrence with oxaliplatin is very unusual. An extensive literature search including PUBMED and direct contact with the drug manufacturer yielded only 2 known case reports. Herein, we describe a case that had classic clinical and radiologic features of RPLS. We also briefly describe 2 other patients who have been described to have RPLS with oxaliplatin in the literature.
可逆性后部白质脑病综合征（RPLS），又称后部可逆性脑病综合征，其特征为磁共振成像（MRI）发现可逆性血管源性皮质下水肿而无梗死。临床表现通常是非特异性的，通常涉及全脑脑病、癫痫发作、头痛或视觉症状。脑 MRI 对 RPLS 的诊断至关重要。RPLS 的典型表现包括 T2 加权图像上以大脑后部为主的高强度信号，这是由皮质下白质血管源性水肿引起的。MRI 上的液体衰减反转恢复（FLAIR）序列可提高敏感性并检测到细微的周边病变。这种临床放射学综合征已在多种医疗条件下得到描述，其中高血压性脑病、子痫和免疫抑制剂药物（最常见的是钙调神经磷酸酶抑制剂）的使用是最常见的。偶尔也有顺铂和卡铂引起的报道。奥沙利铂引起的报道非常罕见。我们进行了广泛的文献检索，包括 PUBMED 和直接联系药物制造商，仅发现了 2 例已知的病例报告。在此，我们描述了一例具有典型临床和放射学特征的 RPLS 病例。我们还简要描述了文献中另外 2 例奥沙利铂引起的 RPLS 患者。
