Chang Yongen, Mbeo Gilbert, Littman Susan J
Department of Medicine, Internal Medicine Residency Program, AtlantiCare Regional Medical Center, Atlantic City, NJ 08401, USA.
J Gastrointest Cancer. 2012 Sep;43(3):505-7. doi: 10.1007/s12029-011-9279-8.
Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare disorder characterized by altered mental status, seizure, hypertension, and symmetrical white matter edema (leukoencephalopathy) typically in the posterior cerebral hemispheres on brain imaging. It is often linked to certain medication use, in particular, chemotherapeutic agents. Here, we present a case of chemotherapy-related RPLS and review the current literature on this topic.
We report a case of RPLS associated with concurrent bevacizumab (Avastin), gemcitabine, and oxaliplatin use for unresectable intrahepatic cholangiocarcinoma.
This is the first reported case of RPLS associated with bevacizumab, gemcitabine, and oxaliplatin combination chemotherapy. Concurrent use of multiple agents could significantly increase the risk of RPLS, a potentially fatal disease. Our case suggests that gradual progression of hypertension and proteinuria may be early warning signs before the onset of RPLS that should alarm clinicians.
可逆性后部白质脑病综合征（RPLS）是一种罕见的疾病，其特征为精神状态改变、癫痫发作、高血压以及脑成像显示典型的大脑后半球对称白质水肿（白质脑病）。它常与某些药物使用有关，特别是化疗药物。在此，我们报告一例与化疗相关的RPLS病例，并回顾关于该主题的当前文献。
我们报告一例RPLS病例，该病例与使用贝伐单抗（阿瓦斯汀）、吉西他滨和奥沙利铂联合治疗不可切除的肝内胆管癌有关。
这是首例报告的与贝伐单抗、吉西他滨和奥沙利铂联合化疗相关的RPLS病例。多种药物同时使用可能会显著增加RPLS（一种潜在致命疾病）的风险。我们的病例表明，高血压和蛋白尿的逐渐进展可能是RPLS发作前的早期预警信号，应引起临床医生的警惕。
