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Reversible posterior leukencephalopathy syndrome induced by granulocyte stimulating factor filgrastim
  1. T LENIGER,
  2. O KASTRUP,
  3. HC DIENER
  1. Department of Neurology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany
  1. Dr Tobias Leniger tobias.leniger{at}uni-essen.de

https://doi.org/10.1136/jnnp.69.2.280

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    Posterior leukencephalopathy syndrome is characterised by visual disturbances, altered mental status, drowsiness, seizures, headache, and occasionally focal neurological signs. It is usually associated with severe hypertension and has most often been seen in patients treated with immunsuppressive drugs such as cyclosporin A, tacrolimus, and interferon-α.1 2

    The granulocyte and granulocyte macrophage stimulating factor filgrastim (Neupogen®) is used in chemotherapy induced bone marrow suppression. By contrast with molgramostim (Leukomax®) filgrastim is supposed to have fewer CNS side effects. Intracranial hypertension and convulsions have been reported after molgrastim therapy. Only one case of recurring encephalopathy and focal status epilepticus due to filgrastim is published.3 In that case the contrast enhanced CT was normal.

    We report a case of reversible posterior leukencephalopathy syndrome with transient bilateral changes …

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