Journal of Blood & Lymph

Posterior Reversible Encephalopathy Syndrome During Induction Treatment of Philadelphia Positive Acute Lymphoblastic Leukemia in an Adult Patient: First Case Report and Literature Review

Abstract

Juliette Reure, Frederic Peyrade, Christine Lebrun-Frenay, Jean Dellamonica, Salvatore Caruso, Esma Saada, Valentine Richez, Sophie Raynaud, Antoine Thyss and Lauris Gastaud

Posterior reversible encephalopathy syndrome (PRES) is a reversible clinical and radiological entity. The circumstances of occurrence are numerous and the pathophysiology is unclear. The main theory is related to the onset of hypertension leading to the deterioration of the cerebral autoregulation. This is an acute or subacute syndrome, often preceded by convulsive episodes. Symptoms are headaches, impaired consciousness, and vomiting or visual disturbances. The brain Magnetic Resonance Imaging (MRI) is the gold standard and highlights evidences of hyperintensities on T2 (bilateral, symmetrical, reversible, and predominantly posterior). Several cases have been reported as a complication during the treatment of childhood acute lymphoblastic leukemia (ALL), but few cases have been published in adult patients and especially in Philadelphia positive ALL. We report the first adult case of Philadelphia positive ALL with development of PRES after induction therapy.