Neurotoxicity is a clinically relevant adverse event observed with the use of ifosfamide. It is usually mild, occasionally severe and seldom fatal. Ifosfamide-induced encephalopathy requires interruption of chemotherapy, intravenous hydration and administration of methylene blue. Less is known about the efficacy of methylene blue in avoiding a second episode of ifosfamide-induced encephalopathy while maintaining chemotherapy with ifosfamide. We report a case of a different clinical manifestation of ifosfamide-induced encephalopathy after continued ifosfamide use and despite methylene blue in a patient with retroperitoneal sarcoma.
ParkI.S., LeeH.J., LeeY.S., HwangJ.S., LeeM.S.: Ifosfamide-induced encephalopathy with or without using methylene blue. Int J Gynecol Cancer, 15: 807–810, 2005.
5.
LerchS., KupferA., IdleJ.R., LauterburgB.H.: Cerebral formation in situ of S-carboxymethylcysteine after ifosfamide administration to mice: a further clue to the mechamism of ifosfamide encephalopathy. Toxicol Lett, 161: 188–194, 2006.
6.
PelgrimsJ., De VosF., Van de BrandeJ., SchrijversD., ProvéA., VermorkenJ.B.: Methylene blue in the treatment and prevention of ifosfamide-induced encephalopathy: report of 12 cases and a review of the literature. Br J Cancer, 82: 291–294, 2000.
