Posterior Reversible Encephalopathy Syndrome in Children With Hematologic Malignancies

• Published in: Journal of child neurology Vol. 30; no. 12; p. 1669
• Main Authors: Tavares, Márcio, Arantes, Mavilde, Chacim, Sérgio, Júnior, António Campos, Pinto, Armando, Mariz, José Mário, Sonin, Teresa, Pereira, Susana
• Format: Journal Article
• Language: English
• Published: United States 01.10.2015
• Subjects: Adolescent; Antineoplastic Agents - therapeutic use; Brain - pathology; Child; Child, Preschool; Female; Follow-Up Studies; Hematologic Neoplasms - complications; Hematologic Neoplasms - epidemiology; Hematologic Neoplasms - physiopathology; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Transplantation; Humans; Infant; Male; Myelodysplastic Syndromes - complications; Myelodysplastic Syndromes - epidemiology; Myelodysplastic Syndromes - physiopathology; Myelodysplastic Syndromes - therapy; Posterior Leukoencephalopathy Syndrome - complications; Posterior Leukoencephalopathy Syndrome - epidemiology; Posterior Leukoencephalopathy Syndrome - physiopathology; Posterior Leukoencephalopathy Syndrome - therapy; Retrospective Studies; Transplantation, Homologous; Treatment Outcome; epilepsy; hematologic malignancies; children; allogenic hematopoietic stem-cell transplant; neurologic complications
• ISSN: 1708-8283
• DOI: 10.1177/0883073815578525

Since its original description 2 decades ago, posterior reversible encephalopathy syndrome has been reported in children with several predisposing conditions. Epidemiologic data of posterior reversible encephalopathy syndrome in children with hematologic malignancies is still scarce. Herein, we describe the clinical and radiologic features along with the outcome and follow-up of posterior reversible encephalopathy syndrome complicating the treatment of children with hematologic malignancies. Ten patients with a median age of 6.3 years were diagnosed with posterior reversible encephalopathy syndrome. Six of them were undergoing chemotherapy and the remaining 4 were at 37, 52, 78, and 857 days after allogenic hematopoietic stem cell transplant. The median follow-up was 27.6 months. Even though follow-up imaging showed complete resolution of abnormalities in those 10 children, 2 developed secondary epilepsy. Despite accurate diagnosis of posterior reversible encephalopathy syndrome and immediate intervention, neurologic sequelae may still develop. Thus, a close follow-up should be considered in all patients.