Reversible posterior leukoencephalopathy syndrome and anti-neoplastic agents: a review

Reversible Posterior Leukoencephalopathy Syndrome (RPLS) is a well recognized entity with a variety of benign and malignant conditions. Recently it has been found to be associated with the use of anti-neoplastic agents including targeted therapies. RPLS occurs rapidly with the use of some drugs and more slowly with others. Combined therapies are associated with a more frequent and more rapid presentation. This review was based on a literature search for English Language articles concerning RPLS and chemotherapeutic agents published from June 1996 to March 2007. We used the PubMed database with keywords: “RPLS”, “Posterior reversible encephalopathy syndrome”, “(PRES)”, “Chemotherapy” and “MRI”. This syndrome has classical Clinical-Radiologic features that are easy to recognize. Early recognition and withdrawal of the offending agent is all that is needed in most cases. This review highlights the features of the syndrome. It draws our attention to an entity which is being more frequently recognized and whose exact pathologic mechanisms need to be further studied. This syndrome is associated with the use of neurotoxic as well as non-neurotoxic agents and usually runs a benign course if there is an early diagnosis and management.

Download Full-text

Don't forget reversible posterior leukoencephalopathy syndrome (RPLS) / posterior reversible encephalopathy syndrome (PRES)

Journal of the Japanese Society of Intensive Care Medicine ◽

10.3918/jsicm.15.480 ◽

2008 ◽

Vol 15 (4) ◽

pp. 480-484 ◽

Cited By ~ 1

Author(s):

Yasuhiro Ito ◽

Makoto Kawai ◽

Takeshi Yasuda

Keyword(s):

Posterior Reversible Encephalopathy Syndrome ◽

Reversible Posterior Leukoencephalopathy Syndrome ◽

Posterior Reversible Encephalopathy ◽

Reversible Posterior Leukoencephalopathy ◽

Posterior Leukoencephalopathy ◽

Reversible Encephalopathy

Download Full-text

Reversible Posterior Leukoencephalopathy Syndrome Developing After Restart of Sunitinib Therapy for Metastatic Renal Cell Carcinoma

Case Reports in Medicine ◽

10.1155/2016/6852951 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Shinji Fukui ◽

Yuta Toyoshima ◽

Takeshi Inoue ◽

Yoriaki Kagebayashi ◽

Shoji Samma

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Vision Loss ◽

Early Recognition ◽

Antihypertensive Agents ◽

Reversible Posterior Leukoencephalopathy Syndrome ◽

Neurological Damage ◽

Reversible Posterior Leukoencephalopathy ◽

Posterior Leukoencephalopathy

A 64-year-old Japanese man had started molecular-targeted therapy with sunitinib for lymph node metastasis 5 years after nephrectomy for left renal cell carcinoma (clear cell carcinoma, G2, pT2N0M0). He was transported to our emergency department because of generalized tonic-clonic seizure, vision loss, and impaired consciousness with acute hypertension after 8 cycles of treatment (2 years after the initiation of sunitinib therapy, including a drug withdrawal period for one year). MRI of the brain (FLAIR images) showed multiple high-intensity lesions in the white matter of the occipital and cerebellar lobes, dorsal brain stem, and left thalamus. Reversible posterior leukoencephalopathy syndrome caused by sunitinib was suspected. In addition to the immediate discontinuation of sunitinib therapy, the administration of antihypertensive agents and anticonvulsants improved the clinical symptoms without neurological damage. Physicians should be aware that sunitinib causes reversible posterior leukoencephalopathy syndrome. The early recognition of reversible posterior leukoencephalopathy syndrome is critical to avoid irreversible neurological damage.

Download Full-text