Keywords
Ifosfamide
methylene blue
thiamine
How to Cite
Abstract
Ifosfamide-related encephalopathy (EII) is a potentially fatal adverse effect, with an incidence between 10 and 30%. According to the literature, the neurotoxic effects occur within the first 5 days of infusion and include fatigue, somnolence, hallucinations, seizures, coma and death. Treatment with methylene blue and thiamine can shorten the duration and severity of symptoms. Case Report: A 43-year-old man with relapsed/refractory Hodgkin Lymphoma receives treatment with ICE protocol (ifosfamide 2500 mg/m2 twice a day) and develops rapidly progressive encephalopathy 72 hours after the infusion. After ruling out infectious and metabolic causes, with a high index of suspicion of ifosfamide-related encephalopathy (EII), he starts treatment with methylene blue and thiamine with a favourable outcome. Discussion: EII is a serious and potentially fatal adverse event diagnosed by excluding other causes of encephalopathy. As such, a high index of suspicion is essential in order to establish an early diagnosis and treatment.
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