Department of Paediatrics, Maastricht University Medical Center, Maastricht, The Netherlands.
Eur J Paediatr Neurol. 2010 Nov;14(6):539-45. doi: 10.1016/j.ejpn.2010.01.003. Epub 2010 Feb 19.
This report describes four patients with acute lymphoblastic leukaemia, suffering from posterior reversible encephalopathy syndrome during the induction period of treatment. A review of the literature on posterior reversible encephalopathy syndrome in paediatric leukaemia is given. The exact mechanism of posterior reversible encephalopathy syndrome is not clear and seems to be multifactorial. Hypertension is likely to play a major role in the development but could be also secondary. All patients in this case series presented after introduction of the new induction protocol for acute lymphoblastic leukaemia. Treatment of hypertension is likely to have a favourable role and posterior reversible encephalopathy syndrome is most often reversible. It is important to consider this diagnosis during the induction phase of leukaemia treatment in the presence of neurological symptoms. The incidence of PRES in the induction scheme should be investigated, in order to optimize the ALL treatment.
本报告描述了 4 例在诱导治疗期间发生后部可逆性脑病综合征的急性淋巴细胞白血病患者。对儿童白血病后部可逆性脑病综合征的文献进行了回顾。后部可逆性脑病综合征的确切机制尚不清楚，似乎是多因素的。高血压可能在其发展中起主要作用，但也可能是继发性的。本病例系列中的所有患者均在采用新的急性淋巴细胞白血病诱导方案后出现。高血压的治疗可能具有有利作用，后部可逆性脑病综合征通常是可逆的。在白血病治疗的诱导阶段出现神经系统症状时，应考虑到这一诊断。应调查 PRES 在诱导方案中的发生率，以优化 ALL 治疗。
