Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma
BackgroundPosterior reversible encephalopathy syndrome (PRES) is characterized by headaches, vision loss, confusion, encephalopathy, seizures, and reversible focal edema on neuroimaging. Early recognition and treatment of PRES are essential to prevent severe complications. Lenvatinib is a multi-targ...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1487009/full |
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| author | Minchun Chen Jing Shen Rongrong Jia Mingze Chang Jingyi Zhang Jie Zheng Runqing Xue Lulu Guo Kangkang Yan |
| author_facet | Minchun Chen Jing Shen Rongrong Jia Mingze Chang Jingyi Zhang Jie Zheng Runqing Xue Lulu Guo Kangkang Yan |
| author_sort | Minchun Chen |
| collection | DOAJ |
| description | BackgroundPosterior reversible encephalopathy syndrome (PRES) is characterized by headaches, vision loss, confusion, encephalopathy, seizures, and reversible focal edema on neuroimaging. Early recognition and treatment of PRES are essential to prevent severe complications. Lenvatinib is a multi-targeted kinase inhibitor that is used as a first-line treatment for patients with hepatocellular carcinoma (HCC). Lenvatinib-induced PRES is a less commonly recognized side effect.Case presentationA 72-year-old female patient with HCC, who had no history of hypertension, received lenvatinib therapy. The patient exhibited symptoms such as confusion, altered mental status, headaches, and severe hypertension during treatment. Neuroimaging revealed characteristic findings of vasogenic edema in the white matter of the brain. The patient’s neurological symptoms gradually improved after lenvatinib discontinuation, and follow-up imaging showed a reduction in the white matter abnormalities.ConclusionThe underlying mechanisms of PRES induced by lenvatinib remain unclear, but hypertension is considered a crucial factor in its pathogenesis. This case report adds to the understanding of the potential adverse effects associated with lenvatinib in patients with HCC, emphasizing the need for vigilance in monitoring and managing such complications to ensure the safety and wellbeing of patients undergoing this treatment. |
| format | Article |
| id | doaj-art-bbb72cc809134a89b9029c70fb779a92 |
| institution | OA Journals |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-bbb72cc809134a89b9029c70fb779a922025-08-20T01:49:14ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.14870091487009Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinomaMinchun Chen0Jing Shen1Rongrong Jia2Mingze Chang3Jingyi Zhang4Jie Zheng5Runqing Xue6Lulu Guo7Kangkang Yan8Department of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Neurology, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Medical Imaging, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Neurology, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaDepartment of Pharmacy, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaBackgroundPosterior reversible encephalopathy syndrome (PRES) is characterized by headaches, vision loss, confusion, encephalopathy, seizures, and reversible focal edema on neuroimaging. Early recognition and treatment of PRES are essential to prevent severe complications. Lenvatinib is a multi-targeted kinase inhibitor that is used as a first-line treatment for patients with hepatocellular carcinoma (HCC). Lenvatinib-induced PRES is a less commonly recognized side effect.Case presentationA 72-year-old female patient with HCC, who had no history of hypertension, received lenvatinib therapy. The patient exhibited symptoms such as confusion, altered mental status, headaches, and severe hypertension during treatment. Neuroimaging revealed characteristic findings of vasogenic edema in the white matter of the brain. The patient’s neurological symptoms gradually improved after lenvatinib discontinuation, and follow-up imaging showed a reduction in the white matter abnormalities.ConclusionThe underlying mechanisms of PRES induced by lenvatinib remain unclear, but hypertension is considered a crucial factor in its pathogenesis. This case report adds to the understanding of the potential adverse effects associated with lenvatinib in patients with HCC, emphasizing the need for vigilance in monitoring and managing such complications to ensure the safety and wellbeing of patients undergoing this treatment.https://www.frontiersin.org/articles/10.3389/fphar.2025.1487009/fullhepatocellular carcinomaposterior reversible encephalopathy syndromelenvatinibadverse drug reactionsPRES |
| spellingShingle | Minchun Chen Jing Shen Rongrong Jia Mingze Chang Jingyi Zhang Jie Zheng Runqing Xue Lulu Guo Kangkang Yan Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma Frontiers in Pharmacology hepatocellular carcinoma posterior reversible encephalopathy syndrome lenvatinib adverse drug reactions PRES |
| title | Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| title_full | Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| title_fullStr | Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| title_full_unstemmed | Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| title_short | Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| title_sort | case report posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma |
| topic | hepatocellular carcinoma posterior reversible encephalopathy syndrome lenvatinib adverse drug reactions PRES |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1487009/full |
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