Behenoyl cytarabine-associated reversible encephalopathy in a patient with acute myelogenous leukemia.
10.3346/jkms.1999.14.1.89
- Author:
Seok Goo CHO
1
;
Hanlim MOON
;
Jae Hee LEE
;
Sung Yong LEE
;
Chun Choo KIM
;
Kyung Shick LEE
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul.
- Publication Type:Case Report
- Keywords:
Cytarabine;
Brain edema;
Drug toxicity;
Leukemia, myelocytic, acute
- MeSH:
Adolescence;
Antineoplastic Agents/therapeutic use;
Antineoplastic Agents/adverse effects*;
Brain/radiography;
Case Report;
Cytarabine/therapeutic use;
Cytarabine/analogs & derivatives*;
Cytarabine/adverse effects;
Female;
Human;
Leukemia, Myelocytic, Acute/drug therapy;
Leukemia, Myelocytic, Acute/complications*;
Magnetic Resonance Imaging;
Seizures/radiography*;
Seizures/chemically induced
- From:Journal of Korean Medical Science
1999;14(1):89-92
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of reversible encephalopathy syndrome in a 16-year-old girl with acute myelogenous leukemia (AML), who is undergoing during consolidation chemotherapy composed of BH-AC (N4-behenoyl-1-beta-D-arabinofuranosyl cytosine) and idarubicin. On the 6th day of chemotherapy, she was in a drowsy state following generalized tonic clonic seizure lasting 20 minutes. MR images revealed extensive cortical and subcortical white matter brain edema. Alertness returned over the 24 hr following by the discontinuation of BH-AC and intravenous administration of diphenylhydantoin, although she complained of intermittent headaches and visual disturbance. She gradually recovered from these symptoms during subsequent 7 days. Previously noted abnormal signal intensities have nearly disappreared on follow-up MRI obtained on the 22nd day after the first seizure. She was discharged without any neurologic sequela. This case suggests that BH-AC, a derivative of cytosine arabinoside (1-beta-D-arabinofuranosylcytosine) could be a cause of reversible encephalopathy syndrome.
