Pediatric Acute Lymphoblastic Leukemia Presenting Posterior Reversible Encephalopathy Syndrome in the Induction Chemotherapy

• Published in: The Japanese Journal of Pediatric Hematology Vol. 19; no. 6; pp. 598 - 602
• Main Authors: INAGAKI, Jiro, PARK, Young Dong, YOSHIOKA, Akira, KISHIMOTO, Tomoko, SAKAKIBARA, Takafumi
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 2005; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: hypertension; induction chemotherapy; pediatric acute lymphoblastic leukemia; posterior reversible encephalopathy syndrome
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.19.598

We report two cases of an 9-year-old girl and a 6-year-old boy diagnosed with acute lymphoblastic leukemia (ALL). They suffered seizures on day 31 and day 20 following the induction chemotherapy. Magnetic resonance imaging (MRI) of the brain revealed multiple high signal intensity lesions in the bilateral occipital-parietal lobes on T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) conditions. On the basis of typical findings in brain MRI and the improvement of their neurological signs, they were diagnosed as having posterior reversible encephalopathy syndrome (PRES). They developed hypertension and acute pancreatitis at the onset of PRES; hypertension as well as induction chemotherapy seemed to contribute to the occurrence of PRES. Using of drugs for hypertension and seizure helped to complete chemotherapies. PRES should be considered as a complication for children with hypertension receiving chemotherapy.