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Fatal misonidazole-induced encephalopathy: an RTOG case report
Cancer
|February 1, 1982
Summary
A fatal case of misonidazole (MISO) induced encephalopathy occurred in a patient experiencing anorexia and dehydration. Elevated serum MISO levels and postmortem findings suggest a link between drug toxicity and these conditions.
Area of Science:
- Neuroscience
- Pharmacology
- Toxicology
Background:
- Misonidazole (MISO) is a nitroimidazole drug used in cancer therapy.
- Central nervous system (CNS) toxicity is a potential adverse effect of MISO treatment.
Observation:
- A patient developed fatal encephalopathy after receiving a cumulative dose of 18 g of MISO over five weeks.
- Anorexia and dehydration were noted prior to the onset of neurological symptoms.
- Markedly elevated serum MISO levels were detected four hours post-administration.
Findings:
- Postmortem examination revealed focal cortical neuronal necrosis and hemorrhage.
- Focal demyelination was also observed in the brain.
- These neuropathological findings are consistent with MISO-induced neurotoxicity.
Implications:
- The case highlights the potential for severe CNS toxicity with MISO.
- Dehydration or altered drug metabolism may play a role in MISO neurotoxicity.
- Careful monitoring of MISO levels and patient hydration is crucial during treatment.