scholarly journals Posterior reversible encephalopathy syndrome in an AIDS patient with acute renal failure and hypertension

2013 ◽  
pp. 190-193
Author(s):  
Olivia Bargiacchi ◽  
Anna M. Salerno ◽  
Antonella Rossati ◽  
Roberta Brondolo ◽  
Diego Brustia ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Antihypertensive Agents ◽  
Endothelial Damage ◽  
Mri Findings ◽  
Predisposing Factor ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Introduction: The posterior reversible encephalopathy syndrome (PRES) is a neurological entity characterized by magnetic resonance imaging (MRI) evidence of bilateral subcortical edema in the occipital regions of the brain. Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement. Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

scholarly journals Postpartum Posterior Reversible Encephalopathy Syndrome – A Case that can Press Hard an Obstetrician

2017 ◽  
Vol 31 (1) ◽  
pp. 46-49
Author(s):  
Fahmida Rashid ◽  
Md Abdus Sattar
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Hypertensive Encephalopathy ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Prompt Diagnosis ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a recently described clinicoradiologic entity that is associated with several medical conditions like hypertensive encephalopathy and eclampsia. It present with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic edema can be observed on imaging modalities. It rarely occurs without seizures. There have been reports about PRES associated with pregnancy, especially peripartum. It is often, but not always, associated with high blood pressure. The pathophysiology of PRES is not still clear. Here we report a 23-yearold primigravida with unremarkable antenatal period but complicated by PRES with seizures at her 5th postpartum day. Postictal findings reported headache and magnetic resonance imaging (MRI) findings suggested that PRES were evident. Clinical improvement with complete resolution without any complications was observed on the 8th post operative day with supportive treatment. This case report highlights the importance of awareness, prompt diagnosis and treatment to improve the outcome in this potentially life-threatening, but reversible condition.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 46-49

scholarly journals Immunosuppression-associated posterior reversible encephalopathy syndrome in an acute leukemia case

2018 ◽  
Vol 10 (4) ◽  
Author(s):  
Umit Y. Malkan ◽  
Gursel Gunes ◽  
Haluk Demiroglu ◽  
Hakan Goker
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Lymphoblastic Leukemia ◽  
Immunosuppressive Agents ◽  
Cerebellar Hemisphere ◽  
Hematopoietic Stem ◽  
Posterior Reversible Encephalopathy ◽  
Gvhd Prophylaxis ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) was described in 1996. Herein, we aimed to report an immunosuppression- related PRES case. A 34-year-old woman was diagnosed as t-cell acute lymphoblastic leukemia and allogeneic hematopoietic stem cell transplantation (HSCT) was performed. Cyclosporine was given for GVHD prophylaxis in addition to the other routine medications of HSCT. She was hospitalized for acute renal failure and due to the possible contribution of acute renal failure cyclosporine was stopped. Tacrolimus was started for GVHD prophylaxis at a dose of 1 mg/day. However, fifteen days after the initiation of tacrolimus, blurred vision occurred in our patient. Petechial bleeding sites were detected in bilateral cerebral and cerebellar hemisphere by MR imaging. Tacrolimus dosage was reduced to 0.5 mg/day. She had hypertension which was difficult to control and followed-up in the intensive care unit. She had seizures. Control cranial MR resulted as diffusion limitation in bilateral cerebellar hemisphere, bilateral occipital and frontal-parietal regions with vasogenic edema findings; contrast involvement in left frontal-parietal and right cerebellar regions. She had vision loss and lethargy. Control cranial MR favored PRES syndrome secondary to immunosuppression. Hypertensive state was taken under control with antihypertensive treatment and all immunosuppressive agents were stopped. Two weeks later her clinical condition was slightly improved. MR test which was conducted 2 weeks after the diagnosis revealed the regression of PRES lesions. The characteristic signs on neuroimaging are the symmetrical white matter edema in the posterior cerebral hemispheres, particularly the parietal- occipital regions. In conclusion, PRES rarely develops secondary to the immunosuppressive agents and the clinicians should suspect and promptly diagnose PRES which might cause otherwise serious irreversible clinical complications.

scholarly journals Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia

2018 ◽  
Vol 31 (6) ◽  
pp. 338
Author(s):  
Ana Ponciano ◽  
Vera Vieira ◽  
José Leite ◽  
Célio Fernandes
Keyword(s):  
Renal Failure ◽  
Immunosuppressive Therapy ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Normotensive Patient ◽  
Posterior Reversible Encephalopathy ◽  
Severe Hypercalcemia ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause.

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.

Posterior Reversible Encephalopathy (PRES) in a Child with Severe Dengue

2019 ◽  
Vol 66 (3) ◽  
pp. 322-326
Author(s):  
Yogini Sawant ◽  
Suresh Birajdar ◽  
Hiren Doshi ◽  
Pooja Soni ◽  
Deepak Patkar ◽  
...  
Keyword(s):  
Pediatric Population ◽  
White Blood Cells ◽  
Neurological Complications ◽  
Severe Dengue ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Changes ◽  
Reversible Encephalopathy ◽  
Csf Examination

Abstract Among neurological complications associated with dengue, posterior reversible encephalopathy syndrome (PRES) has not been reported in pediatric population. We report a 10-year-old girl with severe dengue who developed PRES. The patient presented with hemorrhagic shock that required fluid resuscitation and inotropic support. She developed seizures with encephalopathy 2 days after recovering from the shock. Cerebrospinal fluid (CSF) examination was negative for dengue (no white blood cells in CSF with negative polymerase chain reaction for dengue). Her clinical features and magnetic resonance imaging (MRI) findings showed typical changes associated with posterior encephalopathy that reverted after resolution of hypertension. Repeat MRI after a month was normal. PRES should be considered as a possible differential diagnoses of dengue associated encephalopathy, especially in cases with normal CSF examination and characteristic MRI changes.

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