Abstract
We describe a normotensive patient who developed posterior reversible encephalopathy
syndrome following prolonged use of dexamethasone for nausea control with cisplatin
and pemetrexed chemotherapy. A 32-year-old woman with advanced intraperitoneal mesothelioma
developed new-onset seizures and cognitive impairment. MRI of the brain demonstrated
several areas of increased signal on T2-weighted and fluid-attenuated inversion recovery
sequences within the subcortical white matter of both hemispheres. Chemotherapy was
discontinued and dexamethasone tapered-off. She returned to her baseline with resolution
of MRI abnormalities. We hypothesize that extended use of dexamethasone potentiated
the relatively uncommon complication of leukotoxicity associated with cisplatin, and
we elaborate on dexamethasone’s contribution.
Keywords
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Article info
Publication history
Accepted:
May 23,
2009
Received:
May 20,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
