Nan Di, Yin Xiang, Ma Di, Jiang Xiaoyu, Wu Baihua, Feng Jiachun
Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2021 May 6;12:546481. doi: 10.3389/fneur.2021.546481. eCollection 2021.
Posterior reversible encephalopathy syndrome (PRES) is a relatively rare clinical disease, characterized by reversible subcortical vasogenic edema. Here, we present the first reported case of PRES induced by anlotinib, a multi-target tyrosine kinase inhibitor. A 56-year-old female patient with lung adenocarcinoma and bone metastasis experienced hypertension and mental confusion when she received anti-angiogenesis treatment. PRES was diagnosed after magnetic resonance of the patient's brain revealed hyperintensities bilaterally around the cerebellum, pons, fronto-parieto-occipital areas, and corona radiate. Diffusion-weighted imaging showed hyperintensities bilaterally in the parieto-occipital cortical regions. Subsequently, the patient was diagnosed with PRES, and remission was achieved with anti-hypertensive drugs. Six cases of rare adverse effects induced by anlotinib were reviewed in the literature. Since anlotinib has been widely applied as a novel third-line treatment in patients with non-small-cell lung cancer, the association between PRES and anlotinib would benefit neurologists and oncologists in future diagnoses and treatment.
后部可逆性脑病综合征（PRES）是一种相对罕见的临床疾病，其特征为可逆性皮质下血管源性水肿。在此，我们报告首例由多靶点酪氨酸激酶抑制剂安罗替尼诱发的PRES病例。一名56岁的肺腺癌伴骨转移女性患者在接受抗血管生成治疗时出现高血压和精神错乱。患者脑部磁共振成像显示小脑、脑桥、额顶枕区及放射冠周围双侧高信号，诊断为PRES。弥散加权成像显示双侧顶枕叶皮质区高信号。随后，该患者被诊断为PRES，并通过抗高血压药物实现缓解。文献中回顾了6例由安罗替尼诱发的罕见不良反应。由于安罗替尼已被广泛用作非小细胞肺癌患者的新型三线治疗药物，PRES与安罗替尼之间的关联将有助于神经科医生和肿瘤科医生未来的诊断和治疗。
