Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
CASE REPORTS
Bortezomib-induced Posterior Reversible Encephalopathy Syndrome: Clinical and Imaging Features
Chien-Hui HoChung-Ping LoMin-Chien Tu
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JOURNALS OPEN ACCESS

2014 Volume 53 Issue 16 Pages 1853-1857

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Abstract

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.

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© 2014 by The Japanese Society of Internal Medicine
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