Kager Liesbeth M, Kersten Marie-Jose, Kloppenborg Raoul Peter, Van Oers Rien, Van den Born Bert-Jan
Academic Medical Center/University of Amsterdam, Internal Medicine, F4-222, Meibergdreef 9, Amsterdam, 1105AZ, Netherlands.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2009.1926. Epub 2009 Oct 12.
Reversible posterior leucoencephalopathy syndrome (RPLS) is a potentially fatal but reversible clinico-radiological syndrome with symptoms of headache, altered mental functioning, visual changes and seizures in association with typical posterior cerebral white matter lesions. RPLS is associated with the use of cytotoxic drugs, usually in combination with high blood pressure. We report a case of RPLS that we believe is associated with bortezomib, a proteasome inhibitor with proapoptotic and antiangiogenic properties approved for the treatment of relapsed multiple myeloma, and speculate about the possible mechanisms leading to RPLS. Clinicians should be aware of the potential association between RPLS and bortezomib because timely recognition and appropriate treatment are important in the prevention of irreversible neurological complications.
可逆性后部白质脑病综合征（RPLS）是一种潜在致命但可逆转的临床放射学综合征，伴有头痛、精神功能改变、视觉变化和癫痫发作等症状，并伴有典型的大脑后部白质病变。RPLS与细胞毒性药物的使用有关，通常与高血压并存。我们报告了一例我们认为与硼替佐米有关的RPLS病例，硼替佐米是一种具有促凋亡和抗血管生成特性的蛋白酶体抑制剂，已被批准用于治疗复发的多发性骨髓瘤，并推测了导致RPLS的可能机制。临床医生应意识到RPLS与硼替佐米之间的潜在关联，因为及时识别和适当治疗对于预防不可逆的神经并发症很重要。
