A case of 13-year-old girl with acute myeloid leukemia who developed Ogilvie syndrome (acute colonic pseudo-obstruction) and posterior reversible encephalopathy syndrome due to generalized herpes zoster after completion of chemotherapy

DOI
  • Koshiba Mio
    Department of Pediatrics, Toho University School of Medicine
  • Haga Yoichi
    Department of Pediatrics, Toho University School of Medicine
  • Udo Midori
    Department of Pediatrics, Toho University School of Medicine
  • Ueta Yukiko
    Department of Pediatrics, Toho University School of Medicine
  • Matsuoka Masaki
    Department of Pediatrics, Toho University School of Medicine
  • Onagi Chihiro
    Department of Pediatric Surgery, Toho University School of Medicine
  • Shimada Shuhei
    Department of Pediatric Surgery, Toho University School of Medicine
  • Takahashi Hiroyuki
    Department of Pediatrics, Toho University School of Medicine

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Other Title
  • 化学療法終了後に汎発性帯状疱疹によるOgilvie症候群（急性偽性結腸閉塞症）と可逆性後頭葉白質脳症を発症した急性骨髄性白血病の13歳女児例

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Abstract

<p>Ogilvie syndrome, also called acute colonic pseudo-obstruction, is a rare disorder characterized by abrupt and progressive colonic dilatation without mechanical obstruction. We report the case of a 13-year-old girl who complained of severe abdominal pain and constipation two months after the completion of chemotherapy for acute myeloid leukemia. She presented with marked bowel distention, impaired consciousness, and generalized blisters with crust formation. Abdominal computed tomography and brain magnetic resonance imaging showed marked colonic dilatation and a high-intensity area in the occipital lobe, respectively, on T2-weighted images. On the basis of these findings, Ogilvie syndrome and reversible posterior leukoencephalopathy syndrome resulting from generalized herpes zoster were diagnosed. The patient was treated successfully by the administration of acyclovir, neostigmine, dexamethasone, and glycerol and by transanal tube decompression. Immunological recovery after the completion of leukemia treatment takes several months. Therefore, patients should be cautiously monitored keeping in mind the possibility of severe infectious complications even after the completion of chemotherapy.</p>

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