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Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature

RATIONALE: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment. PATIENT CONCERNS: We present a case of RPLS induced by apatinib in this re...

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Autores principales: Lv, Yajuan, Zhang, Yan, Zhang, Jiandong, Liang, Ning, Liu, Fengjun, Liu, Ruixue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6867717/
https://www.ncbi.nlm.nih.gov/pubmed/31725620
http://dx.doi.org/10.1097/MD.0000000000017787
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author Lv, Yajuan
Zhang, Yan
Zhang, Jiandong
Liang, Ning
Liu, Fengjun
Liu, Ruixue
author_facet Lv, Yajuan
Zhang, Yan
Zhang, Jiandong
Liang, Ning
Liu, Fengjun
Liu, Ruixue
author_sort Lv, Yajuan
collection PubMed
description RATIONALE: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment. PATIENT CONCERNS: We present a case of RPLS induced by apatinib in this report. The patient had dizziness and bilateral lower limb weakness after apatinib use for 12 days. DIAGNOSIS AND INTERVENTIONS: Cranial T2-weighted magnetic resonance imaging (MRI) revealed symmetrical increased signal intensity in bilateral areas of the basal ganglia, radiation crown, frontal lobe, parietal lobe, and occipital lobe, which was suggestive of RPLS. The patient discontinued apatinib use and was administered dexamethasone, mannitol, and antihypertensive drugs. OUTCOMES: The patient's blood pressure returned to normal and neurological symptoms improved after 3 days of discontinuation of apatinib use. Moreover, brain MRI showed complete resolution of previous changes after 44 days of discontinuation of apatinib use. LESSONS: Increased blood pressure may damage the normal blood-brain barrier, resulting in the extravasation of the fluid into the brain parenchyma. Hypertension is a significant cause of RPLS. It is important to strictly monitor blood pressure during apatinib treatment.
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spelling pubmed-68677172020-01-14 Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature Lv, Yajuan Zhang, Yan Zhang, Jiandong Liang, Ning Liu, Fengjun Liu, Ruixue Medicine (Baltimore) 5700 RATIONALE: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment. PATIENT CONCERNS: We present a case of RPLS induced by apatinib in this report. The patient had dizziness and bilateral lower limb weakness after apatinib use for 12 days. DIAGNOSIS AND INTERVENTIONS: Cranial T2-weighted magnetic resonance imaging (MRI) revealed symmetrical increased signal intensity in bilateral areas of the basal ganglia, radiation crown, frontal lobe, parietal lobe, and occipital lobe, which was suggestive of RPLS. The patient discontinued apatinib use and was administered dexamethasone, mannitol, and antihypertensive drugs. OUTCOMES: The patient's blood pressure returned to normal and neurological symptoms improved after 3 days of discontinuation of apatinib use. Moreover, brain MRI showed complete resolution of previous changes after 44 days of discontinuation of apatinib use. LESSONS: Increased blood pressure may damage the normal blood-brain barrier, resulting in the extravasation of the fluid into the brain parenchyma. Hypertension is a significant cause of RPLS. It is important to strictly monitor blood pressure during apatinib treatment. Wolters Kluwer Health 2019-11-15 /pmc/articles/PMC6867717/ /pubmed/31725620 http://dx.doi.org/10.1097/MD.0000000000017787 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5700
Lv, Yajuan
Zhang, Yan
Zhang, Jiandong
Liang, Ning
Liu, Fengjun
Liu, Ruixue
Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title_full Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title_fullStr Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title_full_unstemmed Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title_short Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature
title_sort reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: a case report and a review of the literature
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6867717/
https://www.ncbi.nlm.nih.gov/pubmed/31725620
http://dx.doi.org/10.1097/MD.0000000000017787
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