急性淋巴细胞白血病化疗后可逆性后部白质脑病综合征一例并文献复习

目的 探讨急性淋巴细胞白血病巩固化疗后可逆性后部白质脑病综合征(RPLS)的临床表现、诊治及其预后情况.方法 回顾分析1例急性淋巴细胞白血病患者的临床及影像学资料并结合文献进行复习.结果 该患者主要临床表现为腹胀、反复发热,伴乏力症状,经血常规及骨髓相关检查,诊断为早前B细胞性高危组急性淋巴细胞白血病,经诱导缓解化疗及巩固化疗后患者出现血压增高及神经系统症状,结合影像学检查诊断为RPLS,经积极治疗后完全恢复,影像学表现迅速改善.结论 RPLS可由多种病因产生,临床表现及影像学检查缺乏特异性,一般预后较好,早期作出正确诊治是关键.

Reversible posterior leukoencephalopathy syndrome after acute lymphoblastic leukemia chemotherapy: a case report and review of literature

Objective To investigate the clinical manifestations,treatment and prognosis of reversible posterior leukoencephalopathy syndrome (RPLS) after acute lymphoblastic leukemia chemotherapy.Methods The clinical and imaging data of one case with acute lymphoblastic leukemia were analyzed and literatures were reviewed.Results The main clinical presentation of the patient included abdominal distension,repeated fever with fatigue.Depend on the results of the blood routine test and bone marrow relative examinations,the patient was diagnosed as acute lymphoblastic leukemia pro-B cell high risk group.After the induction therapy and consolidation chemotherapy,hypertension and neurological symptoms were appeared.Combined with the imaging examination,it was diagnosed as RPLS.Recieved active treatment,the patient recovered completely,and the imaging test was improved rapidly.Conclusion The causes of RPLS are variety,and its clinical manifestations and imaging test are non-specific.RPLS has a favorable prognosis.The correct diagnosis and treatment are the key points.