Posterior reversible encephalopathy syndrome (PRES) and myeloma

Ricardos Ghanem; Sylvie Glaisner; Arthur Bobin; Anne-Marie Ronchetti; Sophie Cereja; Bertrand Joly; Célia Salanoubat; Guillemette Fouquet

doi:10.1016/j.lrr.2023.100407

Posterior reversible encephalopathy syndrome (PRES) and myeloma

Leuk Res Rep. 2023 Dec 29:21:100407. doi: 10.1016/j.lrr.2023.100407. eCollection 2024.

Authors

Ricardos Ghanem¹, Sylvie Glaisner², Arthur Bobin³, Anne-Marie Ronchetti¹, Sophie Cereja¹, Bertrand Joly¹, Célia Salanoubat¹, Guillemette Fouquet^{1

4}

Affiliations

¹ Centre Hospitalier Sud Francilien, Hématologie clinique, Corbeil-Essonnes, France.
² Département d'oncologie médicale, Institut Curie, Paris, France.
³ Service d'Hématologie et Thérapie Cellulaire, Pôle Régional de Cancérologie, CHU de Poitiers, France.
⁴ Université de Paris, INSERM U1016, Institut Cochin, CNRS UMR8104, Faculté de médecine Cochin-Port Royal, Paris, France.

Abstract

Posterior reversible encephalopathy syndrome (PRES) has rarely been described in myeloma, but chemotherapy is a known risk factor. We report 3 patients with myeloma who developed PRES, and analyzed them with 13 published cases, mostly women. The most frequent causative agents were proteasome inhibitors and autologous stem cell transplantation. Risk factors were frequently associated: hypertension, infection or renal failure. Symptoms included headache, blurred vision, altered mental status, seizures. Most patients experienced rapid clinical recovery, without relapse even after resuming treatment. Although rare, we must remain vigilant about PRES in myeloma patients. Stricter control of blood pressure could limit its occurrence.

Keywords: Cerebrovascular complication; Chemotherapy; Myeloma; Neurotoxicity; Posterior reversible encephalopathy syndrome.

Publication types

Case Reports