scholarly journals Posterior Reversible Encephalopathy Syndrome in a Patient With Microscopic Polyangiitis: A Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Xu ◽  
Ying Ding ◽  
Zhen Qu ◽  
Feng Yu
Keyword(s):  
Adverse Effect ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Characteristics ◽  
Biological Therapy ◽  
Microscopic Polyangiitis ◽  
Posterior Reversible Encephalopathy ◽  
Brain Ct Scan ◽  
Reversible Encephalopathy ◽  
Regular Hemodialysis ◽  
New Onset

Central nervous system (CNS) is rarely involved in microscopic polyangiitis (MPA). Here, we report a 14-year-old girl with MPA who developed new-onset seizures with deterioration of renal function. Her brain CT scan and MRI showed concurrent complications of intracerebral hemorrhage and posterior reversible encephalopathy syndrome (PRES). She got remission with combinations of methylprednisolone pulse, plasma exchange, regular hemodialysis, antiseizure and antihypertension medications. Furthermore, it is crucial to exclude the adverse effect of medications such as corticosteroid and biological therapy. We searched the literatures, retrieved 6 cases of MPA with PRES and summarized their clinical characteristics.

scholarly journals Posterior Reversible Encephalopathy Syndrome Secondary to Cyclophosphamide

2020 ◽  
Author(s):  
E Mohammed ◽  
A Ramrattan ◽  
D Santoriello
Keyword(s):  
Renal Failure ◽  
Autoimmune Diseases ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Cytotoxic Agents ◽  
Impaired Vision ◽  
Posterior Reversible Encephalopathy ◽  
Hypertensive Emergencies ◽  
Autoimmune Processes ◽  
Reversible Encephalopathy ◽  
New Onset

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological diagnosis defined as new onset seizures, headaches, impaired vision and consciousness. PRES is typically associated with hypertensive emergencies and pre-eclampsia but its association with autoimmune diseases is largely multifactorial with the combination of ongoing immunologic processes, sepsis and cytotoxic agents contributing to patient’s presentation. Cyclophosphamide induced PRES is rare and has been reported in cases of patients with renal failure and active autoimmune processes.

scholarly journals Clinical characteristics and outcomes of patients admitted to hospitals for posterior reversible encephalopathy syndrome: a retrospective cohort study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abbas Alshami ◽  
Asseel Al-Bayati ◽  
Steven Douedi ◽  
Mohammad A. Hossain ◽  
Swapnil Patel ◽  
...  
Keyword(s):  
High Risk ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Hypertensive Crisis ◽  
Inpatient Mortality ◽  
Posterior Reversible Encephalopathy ◽  
Presenting Symptoms ◽  
The Mean ◽  
Reversible Encephalopathy

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is usually a benign, yet underdiagnosed clinical condition associated with subacute to acute neurological manifestations primarily affecting white matter. PRES is reversible when recognized promptly and treated early by removal of the insulting factor; however, can lead to irreversible and life-threatening complications such as cerebral hemorrhage, cerebellar herniation, and refractory status epilepticus. Methods We utilized the National Inpatient Sample database provided by the Healthcare Cost and Utilization Project (HCUP-NIS) 2017 to investigate the demographic variables (age, sex, and race) for patients with PRES, concomitant comorbidities and conditions, inpatient complications, inpatient mortality, length of stay (LOS), and disposition. Results A total of 635 admissions for patients aged 18 years or older with PRES were identified. The mean age was 57.2 ± 0.6 years old with most encounters for female patients (71.7%, n = 455) and white as the most prevalent race. Half the patients in our study presented with seizures (50.1%, n = 318), sixty-three patients (9.9%) presented with vision loss, and sixty-four patients (10.1%) had speech difficulty. In addition, 45.5% of patients had hypertensive crisis (n = 289). 2.2% of hospitalizations had death as the outcome (n = 14). The mean LOS was 8.2 (±0.3) days, and the mean total charges were $92,503 (±$5758). Inpatient mortality differed between males and females (1.7% vs. 2.4%) and by race (3.6% in black vs. 1.8% in white) but was ultimately determined to be not statistically significant. Most patients who present with vision disturbance have a high risk of intracranial hemorrhage. Furthermore, end-stage renal disease, atrial fibrillation, and malignancy seemed to be linked with a very high risk of mortality. Conclusion PRES, formerly known as reversible posterior leukoencephalopathy, is a neurological disorder with variable presenting symptoms. Although it is generally a reversible condition, some patients suffer significant morbidity and even mortality. To the best of our knowledge, this is the largest retrospective cohort of PRES admissions that raises clinician awareness of clinical characteristics and outcomes of this syndrome.

scholarly journals Posterior Reversible Encephalopathy Syndrome Is the Common Cause of New-Onset Seizures in the Peripartum Period: A Tertiary Hospital-Based Study in South India

2021 ◽  
Vol 11 (1) ◽  
pp. 49-55
Author(s):  
Jagarlapudi MK Murthy ◽  
Shyam K Jaiswal ◽  
Keshava Anand Gaade
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Tertiary Hospital ◽  
Clonic Seizure ◽  
Seizure Type ◽  
Common Cause ◽  
Posterior Reversible Encephalopathy ◽  
The Common ◽  
Peripartum Period ◽  
Reversible Encephalopathy ◽  
New Onset

Background and Purpose: To study the aetiolgic spectrum of new-onset seizures in the peripartum period in south India.Methods: This is a retrospective analysis of case records of women with new-onset seizures in the peripartum period admitted between 2005 and 2018 (13 years).Results: Of the 41 women (mean age, 26.20 years; range, 19-35 years) admitted, 20 patients (48.7%) had hypertensive disorders of pregnancy (HDP). Generalized tonic-clonic seizure (88%) was the common seizure type. The aetiologies of new-onset seizures were: 1) pregnancy-related aetiologies in 33 (80.5%) and 2) non-pregnancy-related aetiologies in eight (19.5%). Of the pregnancy-related aetiologies, posterior reversible encephalopathy syndrome (PRES) was the commonest cause in 24 patients (58.5%). Seizure cluster presentation was common in patients with PRES (p=0.0087). Of the eight women with non-pregnancy-related aetiologies, endemic central nervous system (CNS) infections accounted for three (7.3%; brain tuberculoma in one and neurocystocercosis in two) of the aetiology. All the women had Glasgow outcome scale-5 outcome.Conclusions: PRES was the common cause of new-onset seizures in peripartum period in this cohort. Endemic infections of CNS accounted for 7.3% of the total aetiological spectrum. This study suggests that the possibility of PRES should be considerd in woman with HDP and seizure cluster in peripartum period.

scholarly journals A study of posterior reversible encephalopathy syndrome in patients with eclampsia

2020 ◽  
Vol 9 (4) ◽  
pp. 1691
Author(s):  
Seeta Garag ◽  
Mubashira Janvekar
Keyword(s):  
Observational Study ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Rural Areas ◽  
Clinical Characteristics ◽  
Prospective Observational Study ◽  
Clinical Profile ◽  
Core Component ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Background: The association of posterior reversible encephalopathy syndrome with eclampsia has recently received a lot of attention recently. Advances in Imaging has led to better understanding of the pathophysiology of eclampsia. Present study was undertaken to study the clinical characteristics of patients with eclampsia with PRES.Methods: This is a prospective observational study of 50 cases of Eclampsia with PRES in a period of 1 year. Patients admitted with Eclampsia were subjected to neuroimaging with CT or MRI and those with diagnosis of Posterior Reversible Encephalopathy Syndrome were included in the study and clinical profile analyzed.Results: Total of 50 patients were studied in the period of 1 year. The average age of patients was 21.8 years, majority of them residing in rural areas (74%) and 72% were referred cases.Conclusions: PRES is now identified as core component of Eclampsia. More studies are required to compare the outcome of Eclampsia associated with PRES and without PRES.

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