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与化疗药物使用相关的后部可逆性脑病综合征:长春瑞滨治疗后的罕见并发症。

Posterior reversible encephalopathy syndrome associated with the use of chemotherapeutic agents: a rare complication after treatment with vinorelbine.

作者信息

Gil Ines, Serrazina Filipa, Pinto Miguel, Viana-Baptista Miguel

机构信息

Neurorradiology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal

Neurology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal.

出版信息

BMJ Case Rep. 2020 Feb 16;13(2):e229319. doi: 10.1136/bcr-2019-229319.

DOI:10.1136/bcr-2019-229319
PMID:32066575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7046420/
Abstract

The posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterised by a combination of headache, encephalopathy, seizures and visual disturbances, associated with high-intensity abnormalities on T2-weighted images affecting subcortical white and grey matter of the occipital and parietal lobes. Among other causes, PRES has been associated with the use of several medications including chemotherapeutic agents. Here we report a case of a 65-year-old patient with squamous cell carcinoma of the lung treated with cisplatin/vinorelbine. Following the second administration of vinorelbine, she was admitted to the hospital for a generalised seizure. Blood pressure was just slightly elevated and, except for drowsiness, she had a near-normal neurological examination. MRI corroborated the diagnosis. Vinorelbine-induced PRES has been reported only once in the literature, also in association with cisplatin. Our case underlines the role of vinorelbine and suggests that its association with cisplatin in this setting may enhance the risk of PRES.

摘要

后部可逆性脑病综合征(PRES)是一种临床放射学综合征,其特征为头痛、脑病、癫痫发作和视觉障碍同时出现,与T2加权图像上影响枕叶和顶叶皮质下白质和灰质的高强度异常有关。在其他病因中,PRES与包括化疗药物在内的多种药物的使用有关。在此,我们报告一例65岁肺鳞状细胞癌患者,接受顺铂/长春瑞滨治疗。在第二次给予长春瑞滨后,她因全身性癫痫发作入院。血压仅略有升高,除嗜睡外,她的神经系统检查基本正常。磁共振成像(MRI)证实了诊断。长春瑞滨诱导的PRES在文献中仅报道过一次,也是与顺铂联合使用时出现。我们的病例强调了长春瑞滨的作用,并表明在这种情况下它与顺铂联合使用可能会增加发生PRES的风险。

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本文引用的文献

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Acute intermittent porphyria presenting with seizures and posterior reversible encephalopathy syndrome: Two case reports and a literature review.以癫痫发作和后部可逆性脑病综合征为表现的急性间歇性卟啉病:两例报告及文献综述
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Posterior reversible encephalopathy syndrome in cancer patients: a single institution retrospective study.癌症患者的后部可逆性脑病综合征:一项单中心回顾性研究。
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