A case of posterior reversible encephalopathy syndrome (PRES) induced by axitinib : Importance of blood pressure control

Abstract

We report a case of posterior reversible encephalopathy syndrome (PRES) in a 67–year–old woman with advanced renal cell carcinoma, who presented with severe hypertension, headache, and generalized seizure 1 week after the administration of axitinib, a selective inhibitor of the vascular endothelial growth factor receptor. Brain magnetic resonance imaging (MRI) on admission revealed T2–weighted hyperintense lesions in both sides of the occipital lobe and cerebellar hemisphere. Symptoms and MRI abnormalities were completely resolved after the administration of antihypertensive treatment and discontinuation of axitinib. The patient resumed axitinib treatment with strict blood pressure control 1 month later and had no recurrence of PRES. Here, we discuss the rechallenge of axitinib treatment and importance of strict blood pressure control, in addition to a literature review.