Gemcitabine Associated With Posterior Reversible Encephalopathy Syndrome (PRES):. A Case Report and Review of the Literature

摘要

Posterior reversible encephalopathy (PRES) is a clinical radiographic syndrome that is often characterized by headaches, altered consciousness, visual disturbances, and seizures in association with typical radiologic findings of vasogenic edema involving bilateral parietal-occipital lobes.1 However, the syndrome is not always reversible, and it is often not confined to either the white matter or the posterior regions of the brain. The patho-genesis remains unclear but is usually associated with hypertensive encephalopathy, eclampsia, renal failure, general anesthesia, and several immunosuppressants. Chemotherapy agents (eg, cisplatin, cytarabine, and gemcitabine'' [Gemzar, Eli Lilly]) and targeted therapies (including rituximab [Rituxan, Genentech/Biogen Idee Pharmaceuticals] and bevacizumab [Avastin, Genen-tech]) have been shown to cause PRES. After reviewing the literature, there are 5 cases in which gemcitabine was reported to cause PRES, usually when combined with other chemotherapy, primarily cisplatin. In this case, we describe a patient who developed PRES and occlusion of the celiac artery, renal vein, and splenic vein while receiving single-agent gemcitabine for meta-static breast cancer.