Resumen de Managing ifosfamide induced encephalopathy with methylene
M. Real Panisello, Asunción Juárez Marroquí, Carmen Hernández Prats, S. Blasco Mollá, S. Maciá Escalante
Objective: To describe the case of a patient diagnosed with extra-skeletal Ewing's sarcoma who developed encephalopathy after the administration of ifosfamide. Case report: A 21-year-old woman, diagnosed with extra-skeletal Ewing's sarcoma and hepatic metastasis. We initiated second-line treatment, administering high doses of ifosfamide and etoposide. After the first day of treatment, the patient suffered encephalopathy syndrome associated to ifosfamide thus initiating treatment with methylene blue. On the third day of treatment, there was an obvious clinical improvement with the resolution of neurological clinic. Discussion: The etiology of ifosfamide induced encephalopathy is unknown. In the reversal of ifosfamide induced encephalopathy with methylene blue have been reported based on its use in congenital glutaric aciduria, a disease which common denominator with ifosfamide induced encephalopathy is the presence of glutaric acid and sarcosine in urine. Although we have been unable to establish the role of the methylene blue in the recovery of the patient we recommended its use in the severe cases of encephalopathy until further clarification of treatment in future studies
