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Pazopanib-induced posterior reversible encephalopathy syndrome with possible syndrome of inappropriate secretion of antidiuretic hormone: an incidental or pathophysiological association?

机译:Pazopanib诱导的后逆转性脑病综合征,可能的抗性激素的不恰当分泌综合征:偶然或病理生理学协会?

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Introduction: Pazopanib is an oral protein kinase inhibitor (PKI) that targets vascular endothelial growth factor (VEGF) receptors, fibroblastic growth factor receptors, platelet-derived growth factor receptors, and stem cell factor that inhibits VEGFinduced cellular proliferation. Pazopanib is approved for use in advanced renal cell carcinoma and subtypes of advanced softtissue sarcoma (Deguchi et al., 2018). Major adverse drug reactions of pazopanib include hypertension, high-grade hyponatremia and posterior reversible encephalopathy syndrome (PRES) (Berardi et al., 2016; Deguchi et al., 2018). In clinical trials, few investigations have been conducted to determine the aetiology of PKI-associated hyponatremia, the mechanism remains therefore unknown. Only rare cases of PKI-induced syndrome of inappropriate secretion of antidiuretic hormone (SIADH) (Largeau et al., 2019), and none with pazopanib, have been reported. PRES is a clinical and radiological entity where a bilateral white matter oedema, occurring predominantly in the posterior occipital and parietal lobes, is associated with several neurologic symptoms. Interestingly, a recent review suggests that SIADH could be a symptom of PRES (Largeau et al., 2019). To our knowledge, this is the first case published where pazopanib-induced PRES occurs contemporaneously with possible SIADH.
机译:介绍:Pazopanib是一种口服蛋白激酶抑制剂(PKI),其靶向血管内皮生长因子(VEGF)受体,纤维细胞生长因子受体,血小板衍生的生长因子受体和干细胞因子,抑制VEGFINGED细胞增殖。 Pazopanib被批准用于晚期肾细胞癌和晚期Softistisue Sarcoma的亚型(Deguchi等,2018)。 Pazopanib的主要不良药物反应包括高血压,高级低钠血症和后逆转脑病综合征(Pres)(Berardi等,2016; Deguchi等,2018)。在临床试验中,已经进行了很少的调查以确定PKI相关的低钠血症的疾病,因此该机制仍然未知。据报道,只有罕见的PKI诱导的抗性抗性患者分泌(SIADH)(SIADH)(Largeau等,2019)和麻痹的综合征病例。 Pren是一种临床和放射实体,其中主要白质水肿主要在后枕和椎管裂片中发生,与几种神经系统症状有关。有趣的是,最近的评论表明SIADH可能是PRES的症状(Largeau等,2019)。据我们所知,这是第一个发布的案例,其中Pazopanib诱导的Prans与可能的SIADH一起发生。

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