Ruiz-Morales JM, Dorantes-Heredia R, Darwich-del Moral GA, kinney-Novelo IM, Green-Renner D

Language: Spanish
References: 14
Page: 27-30
PDF size: 221.88 Kb.

ABSTRACT

Introduction. Ifosfamide is an alkylating agent and structural analogue of cyclophosphamide. The mechanism that causes ifosfamide neurotoxicity is complex. It has been suggested that chloroethylamine and chloroacetaldehyde metabolites cause accumulation of Nicotinamide adenine dinucleotide and inhibition of mitochondrial respiration. The clinical picture varies from drowsiness and lethargy, to irritability, asterixis, agitation, disorientation, confusion, weakness, hallucinations and seizures. These symptoms start 2 to 48 h after initiation of infusion, to one to three days later. In the Latino population is rare compared to European population (30% of cases). The cause of this difference is unknown. Case report. Female 45 years old, known for our service as uterine leiomyosarcoma metastatic disease. Initially, she was treated with trabectedin for six cycles. Subsequently, it was documented progression disease. It was began second-line scheme with ifosfamide. After 72 h after infusion, the patient began with hallucinations. It was confirmed the absence of other causes of encephalopathy by laboratory, computed tomography and magnetic resonance. She was treated with thiamine infusion, without neurological sequelae and successfully event resolved. There was no clinical recurrence when prophylaxis was introduced to prevent this adverse effect. Conclusion. Ifosfamide encephalopathy is a rare side effect, but characteristic of this drug.

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