Yeo Kee Kiat, HaDuong Josephine H
*Children's Center for Cancer and Blood Diseases, Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles †Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA.
J Pediatr Hematol Oncol. 2016 Aug;38(6):489-90. doi: 10.1097/MPH.0000000000000527.
Encephalopathy is a common side effect of ifosfamide, occurring in up to 30% of patients. Although self-resolving in most cases, death secondary to severe encephalopathy has been reported. Methylene blue and thiamine have been occasionally successful as treatment. We report a case of an 11-year-old girl with relapsed neuroblastoma who developed grade 4 ifosfamide-induced encephalopathy. She showed no initial response to methylene blue and thiamine. She remained neurologically impaired and continuous veno-venous hemodiafiltration was started, with rapid resolution of encephalopathy. This is the first report of continuous veno-venous hemodiafiltration use for suspected ifosfamide-induced encephalopathy in the pediatric population.
脑病是异环磷酰胺常见的副作用,高达30%的患者会出现。虽然大多数情况下可自行缓解,但也有继发于严重脑病而死亡的报道。亚甲蓝和硫胺偶尔治疗成功。我们报告一例11岁复发性神经母细胞瘤女孩,发生了4级异环磷酰胺诱导的脑病。她最初对亚甲蓝和硫胺无反应。她仍有神经功能损害,遂开始持续静静脉血液透析滤过,脑病迅速缓解。这是儿科人群中疑似异环磷酰胺诱导的脑病使用持续静静脉血液透析滤过的首例报告。