Journal of Pharmacovigilance

Abstract

Posterior Reversible Encephalopathy Syndrome after a First Injection of Cyclophosphamide: A Case Report

Lucie-Marie Scailteux, Laurent Hudier, Eric Renaudineau, Patrick Jego and Thomas Drouet

Posterior reversible encephalopathy syndrome is a clinical radiological syndrome, characterized by acute headache, altered consciousness, seizures and hypertension. The most frequent causes are hypertensive encephalopathy, eclampsia and some immunosuppressive therapies. Here, we describe a 75-year-old man with high blood pressure and anti-neutrophil cytoplasmic antibody associated vasculitis with crescentic glomerulonephritis who was treated with cyclophosphamide bolus and corticoids. Symptoms of posterior reversible encephalopathy syndrome have appeared during a hypertensive crisis, 3 days after cyclophosphamide infusion. Cyclophosphamide was stopped and rituximab therapy introduced. The patient recovered promptly. There are only a few reports of posterior reversible encephalopathy syndrome where cyclophosphamide is the only one culprit and they all concern patients with renal disease.