Open AccessCyclophosphamide-induced reversible posterior leukoencephalopathy syndrome
Author(s) -
María José Abenza-Abildúa,
Blanca Fuentes,
Domingo Díaz,
Arantxa Royo,
Teresa Olea,
María José Aguilar-Amat,
E. Díez Tejedor
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.07.2008.0467
Subject(s) - medicine , posterior reversible encephalopathy syndrome , cyclophosphamide , leukoencephalopathy , rituximab , hypertensive encephalopathy , prednisone , eclampsia , immunosuppression , gastroenterology , pathology , blood pressure , magnetic resonance imaging , chemotherapy , disease , radiology , pregnancy , genetics , lymphoma , biology
Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical radiological syndrome, characterised by acute headache, altered consciousness, seizures and hypertension. The most frequent causes are hypertensive encephalopathy, eclampsia and some immunosuppressive therapies. The pathogenesis remains unclear, but it appears to be related to altered cerebral circulation, producing oedema that can be seen on MRI, and it resolves in 2 or 3 weeks. In the present report, a possible first reported case of cyclophosphamide-induced RPLS in a 27-year-old man with high blood pressure (HBP) and glomerulonephritis caused by Goodpasture syndrome, treated with cyclophosphamide during the last month and prednisone for glomerulonephritis resulting from Goodpasture syndrome without other immunosuppressive drugs, is described.Symptoms appeared during a hypertensive crisis, but when cyclophosphamide was replaced by rituximab and hypertension was controlled, the patient did not have neurological symptoms. Almost all reported cases induced by immunosuppressive therapy or other causes were associated with hypertension as well.