Case Report: Ifosfamide neurotoxicty in a young female with a remarkable response to Thiamine

Ifosfamide, a commonly used chemotherapeutic agent in various regimens for many malignancies and has a well known central nervous system side effect. ifosfamide induced encephalopathy develops in approximately 10-30% of patients exposed to the drug. it is generally reversible after discontinuing the therapy; however cases of fatal neurotoxicity have been reported in literature. commonly used antidote, methylene blue; has a moderate efficacy in reversing the encephalopathy followed by lesser response rates by thiamine. we submit a case report of a young female patient with refractory diffuse large b cell lymphoma who developed severe ifosfamide neurotoxicity. with the use of intravenous thiamine, encephalopathy resolved in our patient within a mean time of 30 hours (average range is 10-30 hours). we found thiamine to be safe and effective in treatment for ifosfamide induced encephalopathy.