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Posterior reversible encephalopathy syndrome in childhood cancer

P de Laat1, M L Te Winkel, A S Devos

  • 1Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|August 12, 2010
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) in children with cancer is often triggered by hypertension and presents with seizures. While symptoms typically resolve, some patients may experience lasting neurological issues.

Area of Science:

  • Neurology
  • Pediatric Oncology
  • Radiology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by seizures, headaches, altered mental status, cortical blindness, and transient MRI lesions.
  • PRES is increasingly recognized in pediatric cancer patients, often associated with specific treatments and underlying malignancies.

Purpose of the Study:

  • To investigate the incidence, clinical presentation, and outcomes of PRES in children undergoing cancer treatment.
  • To identify potential triggers and associated factors of PRES in this vulnerable population.

Main Methods:

  • A retrospective review of seven childhood cancer patients with PRES was conducted.
  • A comprehensive literature search identified and analyzed 49 additional well-documented cases of childhood cancer-associated PRES.

Main Results:

  • Fifty-six cases of pediatric cancer-associated PRES were identified, with a mean age of onset at 9 years.
  • Acute lymphoblastic leukemia was the most common primary diagnosis (31 cases), followed by solid tumors (13 cases).
  • Hypertension (49 patients) was the most frequent trigger, and seizures (50 patients) were the most common symptom. Approximately 86% of patients showed reversible clinical and radiological symptoms.

Conclusions:

  • PRES occurs in children with both leukemia and solid tumors, not exclusively in leukemia patients.
  • Hypertension is a critical factor in PRES development during childhood cancer therapy.
  • While most cases resolve, a small percentage (around 10%) may have persistent neurological deficits.
Abstract

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