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BMJ Case Reports 2009; doi:10.1136/bcr.06.2009.1926 

Unexpected outcome (positive or negative) including adverse drug
reactions 
Reversible posterior leucoencephalopathy syndrome associated with
bortezomib in a patient with relapsed multiple myeloma
Liesbeth M Kager, Marie-Jose Kersten, Raoul Peter Kloppenborg, Rien Van
Oers, Bert-Jan Van den Born1 
Published 12 October 2009 
Summary
Reversible posterior leucoencephalopathy syndrome (RPLS) is a
potentially fatal but reversible clinico-radiological syndrome with
symptoms of headache, altered mental functioning, visual changes and
seizures in association with typical posterior cerebral white matter
lesions. RPLS is associated with the use of cytotoxic drugs, usually in
combination with high blood pressure. We report a case of RPLS that we
believe is associated with bortezomib, a proteasome inhibitor with
proapoptotic and antiangiogenic properties approved for the treatment of
relapsed multiple myeloma, and speculate about the possible mechanisms
leading to RPLS. Clinicians should be aware of the potential association
between RPLS and bortezomib because timely recognition and appropriate
treatment are important in the prevention of irreversible neurological
complications. 


Brynn Beals, MLS, AHIP
Library Program Manager
Franciscan Health System
St. Joseph Medical Center
MS 01-62
PO Box 2197
1717 S. J Street
Tacoma WA 98401-2197
Phone: 253-426-6778
Fax: 253-426-6260
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