Bortezomib-induced posterior reversible encephalopathy syndrome in a patient with newly diagnosed multiple myeloma

Intern Med. 2013;52(1):111-4. doi: 10.2169/internalmedicine.52.8799. Epub 2013 Jan 1.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a known but extremely rare side effect of bortezomib therapy. An unusual case of PRES possibly caused by bortezomib during induction treatment in a patient with multiple myeloma is reported. The patient experienced neither hypertensive crisis nor uremic encephalopathy at the onset of PRES, which are both well-known etiologies of PRES. The patient's PRES-related symptoms resolved completely after discontinuation of bortezomib and administration of a bulk dose of corticosteroids. The importance of early recognition of this potential neurological complication must be emphasized because this new drug is being increasingly prescribed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Boronic Acids / administration & dosage
  • Boronic Acids / adverse effects*
  • Bortezomib
  • Dexamethasone / administration & dosage*
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Posterior Leukoencephalopathy Syndrome / chemically induced*
  • Posterior Leukoencephalopathy Syndrome / diagnosis
  • Posterior Leukoencephalopathy Syndrome / drug therapy
  • Pyrazines / administration & dosage
  • Pyrazines / adverse effects*
  • Recovery of Function
  • Risk Assessment
  • Severity of Illness Index
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Boronic Acids
  • Pyrazines
  • Vincristine
  • Bortezomib
  • Dexamethasone
  • Doxorubicin

Supplementary concepts

  • VAD protocol