Treating Acute Toxo-Metabolic Encephalopathy With Continuous Renal Replacement Therapy: A Case Report of Ifosfamide Neurotoxicity

TL;DR

A patient with severe neurological symptoms from Ifosfamide chemotherapy improved rapidly after receiving continuous dialysis.

Contribution

This case report demonstrates the effectiveness of continuous renal replacement therapy in treating Ifosfamide-induced encephalopathy.

Findings

The patient showed rapid and complete recovery after starting continuous venovenous hemodialysis.

Initial treatment with methylene blue failed to improve the patient's condition.

Ifosfamide-induced encephalopathy can be effectively managed with renal replacement therapy.

Abstract

Acute toxometabolic encephalopathy, which encompasses delirium and the acute confusional state, is a condition of global cerebral dysfunction in the absence of primary structural brain disease. Ifosfamide is an alkylating agent used in chemotherapy for the treatment of hematological and various solid tumors and is associated with dose-dependent central nervous system toxicity. We report a case of a patient who developed severe neurological symptoms and encephalopathy after receiving Ifosfamide, a chemotherapy agent. Despite initial management with intravenous methylene blue, the patient continued to deteriorate. Initiation of continuous venovenous hemodialysis 14 hours after symptom onset resulted in rapid and complete recovery.

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