Reversible posterior leukoencephalopathy syndrome: report of 2 simultaneous cases in children

J Pediatr Hematol Oncol. 2006 Mar;28(3):177-81. doi: 10.1097/01.mph.0000210406.82050.07.

Abstract

Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare complication of cancer chemotherapy. We have recently observed two cases occurred simultaneously in children receiving different chemotherapy regimens, for hepatoblastoma and acute lymphoblastic leukaemia, respectively. Both children presented with altered mental status, severe visual disturbances, headache, seizures, backpain and hypertension. Magnetic resonance imaging showed cortical and subcortical lesions especially in the occipital and parietal regions, strongly consistent with RPLS. Both patients completely recovered from their neuropsychologic deficits in about ten days only with anticonvulsant and antihypertensive therapy, and chemotherapy regimen was promptly restarted according to the planned protocol, without any neuropsychological sequela. A mild left midriasis was the only neurologic defect that persisted in the patient with acute lymphoblastic leukemia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Agents / adverse effects*
  • Brain Diseases / etiology*
  • Brain Diseases / pathology
  • Brain Diseases / physiopathology
  • Child
  • Hepatoblastoma / complications*
  • Hepatoblastoma / drug therapy
  • Humans
  • Liver Neoplasms / complications*
  • Liver Neoplasms / drug therapy
  • Magnetic Resonance Imaging
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy

Substances

  • Antineoplastic Agents