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CASE REPORT
Oxaliplatin-induced posterior reversible encephalopathy syndrome (PRES)
  1. Taimoor Khalid Janjua1,
  2. Muhammad Hassan2,
  3. Hira Khan Afridi1,
  4. Naila Anjum Zahid1
  1. 1Department of Oncology, Liaquat National Hospital and Medical College, Karachi, Pakistan
  2. 2Department of Medicine, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  1. Correspondence to Dr Muhammad Hassan, dr.hassanzulfiqar{at}gmail.com

Summary

Posterior reversible encephalopathy syndrome (PRES), first introduced in 1996, is a neurotoxic state characterised by seizures, headache, vision change, paresis, nausea and altered mental status. Risk factors include hypertension, eclampsia/pre-eclampsia, infection/sepsis and cancer chemotherapy. Although exposure to toxic agents is a common occurrence in patients who develop PRES, oxaliplatin has rarely been associated with it, with only 10 cases reported worldwide. We present the case of an oxaliplatin-induced PRES in a 23-year-old male patient who was started on oxaliplatin/capecitabine as adjuvant chemotherapy for anal canal adenocarcinoma. The patient developed symptoms of headache, slurred speech and left-sided facial weakness on the ninth day after the first dose of oxaliplatin that lasted for 6–8 hours. The patient experienced another episode next day with similar symptoms that lasted for 8 hours. Oxaliplatin was withheld and the patient was discharged on capecitabine only. The patient had no new episodes since discharge on follow-up.

  • oncology
  • carcinogenesis
  • chemotherapy
  • colon cancer
  • unwanted effects / adverse reactions
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Footnotes

  • Contributors TKJ and MH wrote the manuscript and did the major work in conceptualisation, literature review and initial draft preparation. HKA and NAZ did the final revision and changes.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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