Lung Transplantation and Posterior Reversible Encephalopathy Syndrome: A Case Series

2012 ◽  
Vol 44 (7) ◽  
pp. 2022-2025 ◽  
Author(s):  
L. Rosso ◽  
M. Nosotti ◽  
P. Mendogni ◽  
A. Palleschi ◽  
D. Tosi ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Case Series ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals A broad spectrum of posterior reversible encephalopathy syndrome - a case series with clinical and paraclinical characterisation, and histopathological findings

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatme Seval Ismail ◽  
Johannes van de Nes ◽  
Ilka Kleffner
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Brain Mri ◽  
Case Series ◽  
Epileptic Seizures ◽  
Retrospective Case ◽  
Posterior Reversible Encephalopathy ◽  
Histopathological Findings ◽  
Delay In Diagnosis ◽  
Reversible Encephalopathy

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is clinical-neuroradiologically defined and potentially reversible, so there are limited data about histopathological findings. We aimed to describe the clinical and paraclinical features of patients with PRES with regard to its reversibility. Methods This retrospective case series encompasses 15 PRES cases out of 1300 evaluated patients from a single German center between January 1, 2010, and June 15, 2020. PRES was established according to the diagnostic criteria as proposed by the Berlin PRES Study 2012. One of the cases studied was subject to brain autopsy. Results From the 15 patients studied (median age 53 years, range 17–73; 11 female), 67 % presented with epileptic seizures, 40 % suffered from encephalopathy with reduced consciousness and 53 % developed delirium, while 47 % had headache and visual disturbances. Subcortical brain MRI abnormalities related to PRES were observed in all patients. One patient developed spinal ischemia and another Guillain-Barré syndrome in addition to PRES. Hypertensive blood pressure was the main underlying/trigger condition in all patients. Clinical symptoms and MRI changes were not reversible in 42 %, even progressive in 3 out of these 5 patients. Median time from symptom onset to diagnosis in these non-reversible cases was 7 days (range 0–13), while the median delay in diagnosis in the reversible group was 1 day (range 0–3). Cerebellar/brain stem involvement and status epilepticus were more frequently in patients with non-reversible disease course. Mortality due to PRES occurred in 13 % of these patients. Neuropathological examination of the brain of a 57-year-old female patient revealed major leukencephalopathic changes, fibrinoid necrosis of endothelial cells and fresh petechial hemorrhages in accordance with PRES. Conclusions Our case series demonstrates that PRES was not reversible in 42 % of the studied patients. Delay in diagnosis seems to contribute to limited reversibility and poor outcome.

scholarly journals Basiliximab for posterior reversible encephalopathy syndrome after lung transplantation

2017 ◽  
Vol 52 (4) ◽  
pp. 823-824 ◽  
Author(s):  
Hiroya Yamagishi ◽  
Toyofumi F. Chen-Yoshikawa ◽  
Hiroshi Date
Keyword(s):  
Lung Transplantation ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Cortical visual loss in posterior reversible encephalopathy syndrome in late postpartum eclampsia: Case series

2014 ◽  
Vol 62 (5) ◽  
pp. 635 ◽  
Author(s):  
Divya Karuppannasamy ◽  
K Vikrant ◽  
A Raghuram ◽  
TM Sathish Kumaar
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Visual Loss ◽  
Case Series ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Immunosuppressive Drugs, an Emerging Cause of Posterior Reversible Encephalopathy Syndrome: Case Series

2015 ◽  
Vol 24 (8) ◽  
pp. e191-e195 ◽  
Author(s):  
Mohammad Hossein Harirchian ◽  
Majid Ghaffarpour ◽  
Mohammad Tabaeizadeh ◽  
Bahaadin Siroos
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Case Series ◽  
Immunosuppressive Drugs ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Clinical Management of Posterior Reversible Encephalopathy Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation: A Case Series and Review of the Literature

2015 ◽  
Vol 135 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Volker Schmidt ◽  
Tino Prell ◽  
Anne Treschl ◽  
Anne Klink ◽  
Andreas Hochhaus ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Mtor Inhibitor ◽  
Case Series ◽  
Systemic Infection ◽  
Hematopoietic Stem ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Background: Posterior reversible encephalopathy syndrome (PRES) is a rare but serious complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). Among others, calcineurin inhibitors (CNI) for prophylaxis of graft-versus-host disease (GvHD) may promote the development of PRES, but the pathomechanism is still controversial. Discontinuation of CNI facilitates remission of symptoms but might contribute to the unfavorable prognosis of PRES due to an elevated incidence of GvHD. Methods: This is a case series of 7 patients with PRES from a retrospective analysis of 146 consecutive patients who received alloHSCT for hematologic malignancies. Results: At the onset of PRES, all patients presented a systemic infection, while no influence was seen for underlying disease, conditioning regimen, donor type, or GvHD. Discontinuation of CNI and control of the blood pressure reversed neurological symptoms in 6 patients, while 1 patient died from septic multiorgan failure. After bridging with prednisolone and/or mycophenolic acid, replacement of CNI by the mammalian target of rapamycin (mTOR) inhibitor everolimus effectively prevented severe GvHD without recurrence of PRES. Conclusions: A systemic infection/inflammation may be an important cause of PRES. Prophylaxis of GvHD by the mTOR inhibitor everolimus in case of PRES after alloHSCT demonstrated promising results but needs to be validated in larger cohorts.

scholarly journals Tacrolimus Associated Posterior Reversible Encephalopathy Syndrome – A Case Series and Review

2014 ◽  
Vol 6 (1) ◽  
pp. e2014014 ◽  
Author(s):  
Susmitha Apuri ◽  
Kristin Carlin ◽  
Edward Bass ◽  
Phuong Thuy Nguyen ◽  
John Norman Greene
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Transplant Rejection ◽  
Interleukin 2 ◽  
Case Series ◽  
Sudden Onset ◽  
Immunosuppressive Drug ◽  
Solid Organ ◽  
Posterior Reversible Encephalopathy ◽  
Hematopoietic Transplantation ◽  
Reversible Encephalopathy

Tacrolimus is an immunosuppressive drug mainly used to lower the risk of transplant rejection in individuals who are post solid organ or hematopoietic transplantation. It is a macrolide which reduces peptidyl-propyl isomerase activity and inhibits calcineurin, thus inhibiting T-lymphocyte signal transduction and interleukin-2 (IL-2) transcription. It has been associated with Posterior Reversible Encephalopathy Syndrome (PRES), a disease of sudden onset that can present as a host of different symptoms, depending on the affected area of the brain. While infectious causes of encephalopathy must always be entertained, the differential diagnosis should also include PRES in the appropriate context. We report three cases of PRES in patients with acute myeloid leukemia (AML) placed on tacrolimus after receiving a bone marrow transplant (BMT). The focus of this review is to enhance clinical recognition of PRES as it is related to an adverse effect of Tacrolimus in the setting of hematopoietic transplantation.

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