scholarly journals Blood transfusion‐induced posterior reversible encephalopathy syndrome presenting severe brain atrophy: A report of two cases

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Wataru Shiraishi
Keyword(s):  
Blood Transfusion ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Brain Atrophy ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Posterior Reversible Encephalopathy Syndrome Following Blood Transfusion: A Rare Case Report with Literature Review

2021 ◽  
Vol 15 (1) ◽  
pp. 31-36
Author(s):  
Jayanti K Gurumukhani ◽  
Harsh D. Patel ◽  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Maitri M. Patel ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Red Cell ◽  
Chronic Anemia ◽  
Posterior Reversible Encephalopathy ◽  
Altered Sensorium ◽  
Mri Brain ◽  
Mri Features ◽  
Reversible Encephalopathy

Background: Posterior reversible encephalopathy syndrome (PRES) is clinicoradiological disease entity characterized by headache, seizures, altered sensorium and corticalvisual loss with characteristic MRI features of subcortical white matter hyperintensities on T2W imaging. Though hypertension is a traditional hallmark of PRES, uncommon causes without hypertension have been described. We report an unusual such case without hypertension, precipitated by red cell transfusion. Case Presentation: A 40 years female received six units of packed cell transfusion for severe anemia (Hemoglobin 3.0 Gm %) transfused over 8 hours. She was having menorrhagia and was operated on for a hysterectomy. She developed a headache on the second postoperative day for five days and no cause was revealed in spite of extensive workup, including MRI brain and CSF study. On the sixth day, she had recurrent seizures followed by altered sensorium in the absence of hypertension. Her repeat MRI brain findings were consistent with PRES. Conclusion: We reviewed 25 cases, including the present one as PRES after the blood transfusion. 24 were females, and 16 of 19 developed PRES in the course of chronic anemia lasting over 1 month. Anemia was severe in 18 of 25 cases, with haemoglobin (Hb) levels < 4.0 Gm%. In 16 of 20 cases, Hb levels increased to 5 g/dl by red cell blood transfusion until the onset of PRES. On MRI brain, 23 of 25 cases showed vasogenic edema and 3 of 25 cases showed an irreversible neurological deficit. When treating severe chronic anemia rapid correction of Hb with blood transfusion, one should consider a possibility of PRES in post-transfusion neurological symptoms in spite of normal diagnostic workup.

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