Related Experiment Videos
Cerebral atrophy in an infant following treatment with ifosfamide
C S Bruggers1, H S Friedman, R Tien
1Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
Abstract:
Ifosfamide, a nitrogen mustard derived alkylating agent commonly used in the treatment of solid tumors, has been associated with neurotoxicity in 5-33% of treated patients. Encephalopathy most often occurs during or shortly following drug administration, with increased drowsiness or irritability, confusion, hallucinations, visual blurring, extrapyramidal dysfunction, cranial nerve abnormalities, incontinence, generalized muscle twitching, seizures, and coma reported in infants, children, and older adults. While most reported neurologic abnormalities associated with ifosfamide have been reversible, encephalopathy resulting in death has occurred. We now report an infant who developed ifosfamide-induced encephalopathy, loss of developmental milestones, progressive brain atrophy, and cessation of cranial growth. This is the first case of cerebral atrophy and loss of developmental milestones that has been reported in a pediatric patient treated with ifosfamide. Given the efficacy of this anti-neoplastic agent and its increasing use in pediatrics, further investigation is indicated, especially in infants where brain growth is ongoing.
Insights
Ifosfamide treatment can cause severe neurotoxicity, including brain atrophy and developmental delays in infants. This case highlights the critical need for further research into ifosfamide
Area of Science:
- Oncology
- Neuroscience
- Pediatrics
Background:
- Ifosfamide is an alkylating agent used to treat solid tumors.
- Neurotoxicity affects 5-33% of patients, with symptoms ranging from drowsiness to coma.
- Neurologic abnormalities are typically reversible, but severe outcomes have been reported.
Observation:
- A case report of an infant treated with ifosfamide.
- The infant developed encephalopathy, loss of developmental milestones, and cessation of cranial growth.
- Progressive brain atrophy was observed in the infant.
Findings:
- This is the first reported case of cerebral atrophy and developmental milestone loss in a pediatric patient due to ifosfamide.
- Ifosfamide-induced encephalopathy can lead to severe, irreversible neurological damage in infants.
- The infant's brain growth was ongoing at the time of treatment.
Implications:
- The findings underscore the potential for severe neurotoxicity in pediatric patients, particularly infants.
- Further investigation into ifosfamide's effects on developing brains is warranted.
- Close monitoring for neurotoxicity is crucial in pediatric patients receiving ifosfamide therapy.