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| NEUROIMAGES |
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| Year : 2017 | Volume
: 65
| Issue : 1 | Page : 220 |
Posterior reversible encephalopathy syndrome after high-dose cytarabine in acute myelogenous leukemia
Christopher R Newey1, Premkumar N Chandrasekaran1, Mohammad R Mohebbi2
1 Department of Neurology, University of Missouri-Columbia, Columbia, Missouri, USA
2 Department of Emergency Medicine, University of Missouri-Columbia, Columbia, Missouri, USA
| Date of Web Publication | 12-Jan-2017 |
Correspondence Address:
Dr. Christopher R Newey
Department of Neurology, One Hospital Drive, Columbia, Missouri – 65212
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.198171
How to cite this article:
Newey CR, Chandrasekaran PN, Mohebbi MR. Posterior reversible encephalopathy syndrome after high-dose cytarabine in acute myelogenous leukemia. Neurol India 2017;65:220 |
How to cite this URL:
Newey CR, Chandrasekaran PN, Mohebbi MR. Posterior reversible encephalopathy syndrome after high-dose cytarabine in acute myelogenous leukemia. Neurol India [serial online] 2017 [cited 2021 Jan 18];65:220. Available from: https://www.neurologyindia.com/text.asp?2017/65/1/220/198171 |
A 68-year-old female patient with acute myeloid leukemia (AML), who was being administered high-dose cytarabine (HiDAC), presented with ataxia, dysarthria, and a platelet count of 10 k/uL. Computed tomography of the head showed scattered evidence of cortical and subarachnoid hemorrhage [Figure 1]a, solid arrow]. Magnetic resonance imaging of the brain showed bilateral, posterior subcortical white matter hyperintense lesions [Figure 1]b, dashed arrow]. She had neither evidence of associated blood pressure lability or kidney failure, nor had undertaken immunomodulatory therapy. | Figure 1: (a) Computed tomography of the head showing scattered cortical subarachnoid hemorrhage (solid arrow). (b) Magnetic resonance imaging of the brain showing hyperintense lesions predominantly posteriorly on T2 images (left) and fluid-attenuated inversion recovery images (right, dashed arrow)
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Posterior reversible encephalopathy syndrome is thought to be secondary to the loss of autoregulation of cerebral blood flow.[1],[2],[3] It is a well-described phenomenon in the setting of eclampsia, immunosuppression, and renal failure.[1] It is less described in induction chemotherapy with HiDAC for AML and should be recognized as a potential complication.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| » References | |  |
| 1. | Lee VH, Wijdicks EF, Manno EM, Rabinstein AA. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Arch Neurol 2008;65:205-10.  |
| 2. | Battipaglia G, Avilia S, Morelli E, Caranci F, Perna F, Camera A. Posterior reversible encephalopathy syndrome (PRES) during induction chemotherapy for acute myeloblastic leukemia (AML). Ann Hematol 2012;91:1327-8. |
| 3. | Lakhotia M, Pahadiya HR, Singh J, Bhansali S, Choudhary S, Jangid H. Posterior reversible encephalopathy syndrome as a rare presenting feature of acute intermittent porphyria. Neurol India 2015;63:607-9. [ PUBMED]  |
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