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Posterior reversible encephalopathy syndrome in paediatric leukaemia
Bianca Panis1, Annemarie M M Vlaar, Gijs Th J van Well
1Department of Paediatrics, Maastricht University Medical Center, Maastricht, The Netherlands. bianca.panis@mumc.nl
Summary
Posterior reversible encephalopathy syndrome (PRES) can occur in children with acute lymphoblastic leukaemia during induction treatment. Prompt management of hypertension is key, as PRES is often reversible.
Area of Science:
- Neurology
- Pediatric Oncology
- Hematology
Background:
- Acute lymphoblastic leukaemia (ALL) treatment involves intensive induction chemotherapy.
- Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological condition.
- The link between pediatric ALL induction and PRES requires further investigation.
Observation:
- Four pediatric patients with ALL developed PRES during induction therapy.
- All patients were treated with a new induction protocol.
- Neurological symptoms were observed in the context of ALL treatment.
Findings:
- Hypertension appears to be a significant factor in PRES development, potentially secondary.
- PRES in this context was frequently associated with the new ALL induction protocol.
- The exact multifactorial mechanism of PRES remains unclear.
Implications:
- Considering PRES in pediatric ALL patients with neurological symptoms during induction is crucial.
- Investigating the incidence of PRES within ALL induction schemes is necessary.
- Optimizing ALL treatment protocols may involve managing PRES-associated factors like hypertension.
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