Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature

We present a case of RPLS induced by apatinib in this report. The patient had dizziness and bilateral lower limb weakness after apatinib use for 12 days. Diagnosis and interventions: Cranial T2-weighted magnetic resonance imaging (MRI) revealed symmetrical increased signal intensity in bilateral areas of the basal ganglia, radiation crown, frontal lobe, parietal lobe, and occipital lobe, which was suggestive of RPLS. The patient discontinued apatinib use and was administered dexamethasone, mannitol, and antihypertensive drugs. Outcomes: The patient's blood pressure returned to normal and neurological symptoms improved after 3 days of discontinuation of apatinib use. Moreover, brain MRI showed complete resolution of previous changes after 44 days of discontinuation of apatinib use. Lessons: Increased blood pressure may damage the normal blood-brain barrier, resulting in the extravasation of the fluid into the brain parenchyma. Hypertension is a significant cause of RPLS. It is important to strictly monitor blood pressure during apatinib treatment.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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