L-asparaginase-induced posterior reversible encephalopathy syndrome during acute lymphoblastic leukemia treatment in children
L-asparaginase-induced posterior reversible encephalopathy syndrome during acute lymphoblastic leukemia treatment in children
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DOI：
10.1055/s-2008-1076740
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发表时间：
2008-02-01
期刊：
影响因子：
1.4
通讯作者：
Muwakkit, S.
中科院分区：
文献类型：
--
作者：
Hourani, R.;Abboud, M.;Muwakkit, S.
L-天冬酰胺酶是治疗儿童急性淋巴细胞白血病的关键成分。众所周知，除了血管炎和过敏反应外，它还会导致中枢神经系统的凝血异常、血栓形成和出血。本文的目的是介绍与L-天门冬酰胺酶治疗相关的第一例后部可逆性脑病综合征(PRES)。本文报告3例儿童急性淋巴细胞白血病，经L-天门冬酰胺酶治疗后出现癫痫发作和感觉改变。MRI显示脑后部T-2信号增强，提示PRES。我们的两名患者出现感染性休克并恶化，而一名患者好转并完全康复。
L-Asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. The purpose of this article is to present the first case-series of posterior reversible encephalopathy syndrome (PRES) associated with L-asparaginase treatment. We report 3 cases of children with acute lymphoblastic leukemia who developed seizures and altered sensorium after L-asparaginase therapy. MRI showed increased T-2 signal intensity predominant in the posterior regions of the brain suggestive of PRIES. Two of our patients developed septic shock and deteriorated whereas one patient improved and recovered completely.