一名20多岁无病史的妇女在经历了8周的呼吸急促病史后被诊断出患有笨重的II期经典霍奇金淋巴瘤,咳嗽和嗜睡。阿霉素(阿霉素)的方案,博来霉素,开始使用长春碱和达卡巴嗪(ABVD),计划六个周期。在第一个周期中,病人患有严重的高血压。然后,她遭受了两次自我终止的强直-阵挛性癫痫发作。检查和调查诊断为可逆性后部脑病综合征(PRES),在严格控制血压和停止化疗的情况下,在11天内完全缓解。蒽环类药物诱发的心肌病进一步使治疗复杂化,需要改用吉西他滨BVD治疗方案。患者从神经病学和心脏病学的角度完全康复,并完成了六个周期的化疗,通过肿瘤实现完整的代谢反应。我们举例说明了这个案例,描述PRES的鉴别诊断和管理,它与化疗和成功的化疗再激发有关。
A woman in her 20s with no medical history was diagnosed with bulky stage II classic Hodgkin\'s lymphoma after an 8-week history of shortness of breath, cough and lethargy. A regimen of doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) was commenced with six cycles planned. During the first cycle, the patient was profoundly hypertensive. She then suffered two self-terminating tonic-clonic seizures.Examination and investigations diagnosed posterior reversible encephalopathy syndrome (PRES), which resolved completely in 11 days with strict blood pressure control and withholding chemotherapy. Treatment was further complicated by anthracycline-induced cardiomyopathy, requiring a switch in regimen to gemcitabine BVD.The patient made a full recovery from neurology and cardiology perspectives and completed six cycles of chemotherapy, achieving a complete metabolic response by the tumour. We illustrate the case, describe differential diagnoses and management of PRES, its association with chemotherapy and the successful chemotherapy rechallenge.