Bortezomib-induced Posterior Reversible Encephalopathy Syndrome: Clinical and Imaging Features

作者：Ho Chien Hui; Lo Chung Ping; Tu Min Chien^*

来源：Internal Medicine, 2014, 53(16): 1853-1857.

DOI：10.2169/internalmedicine.53.2383

• posterior reversible encephalopathy syndrome
• PRES
• bortezomib
• multiple myeloma
• dose-dependent neurotoxicity

Posterior reversible encephalopathy syndrome (PRES) is a rare and potentially harmful complication in patients receiving targeted chemotherapy. We herein present a case of PRES that occurred after 33 days of high-dose bortezomib treatment and propose both overwhelmed cerebral autoregulation and toxin-mediated blood-brain barrier damage as the underlying mechanisms based on the imaging findings. A favorable recovery was observed two days after achieving stringent hypertension control and withholding bortezomib. Follow-up images obtained two weeks later unveiled a dramatic remission, with faint areas of subcortical hyperintensity in the bilateral parieto-occipital regions. With explicit clinical and imaging features, this case highlights the need for early recognition of PRES during the clinical course of bortezomib therapy.

• 出版日期2014