scholarly journals Recurrent Posterior Reversible Encephalopathy Syndrome Potentially Related to AIDS and End-Stage Renal Disease: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Olivia Hui-Chiun Chang ◽  
Alexandra Stanculescu ◽  
Chi Dola ◽  
William Benjamin Rothwell
Keyword(s):  
Renal Disease ◽  
Blood Brain Barrier ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
End Stage Renal Disease ◽  
Brain Barrier ◽  
Posterior Reversible Encephalopathy ◽  
Blood Brain ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome that is characterized by clinical features including headache, altered mental status, cortical blindness, seizures, and other focal neurological signs as well as subcortical edema without infarction on neuroimaging. Under the umbrella of hypertensive encephalopathy, PRES is defined by reversible cerebral edema due to dysfunction of the cerebrovascular blood-brain barrier unit. The pathophysiology of PRES is thought to result from abnormalities in the transmembrane flow of intravascular fluid and proteins caused by two phenomena: one, cerebral autoregulatory failure and two, loss of integrity of the blood-brain barrier. PRES is not a common disease in patients with human immunodeficiency virus (HIV) and AIDS with only three previously reported cases. Both the HIV and end-stage renal disease appear to further compromise the blood brain barrier. Although uncommon, PRES recurrence has been described. To the best of our knowledge, this is the first report demonstrating recurrent PRES in a HIV patient on hemodialysis for end-stage renal disease.

Posterior Reversible Encephalopathy Syndrome: A Noteworthy Syndrome in End-Stage Renal Disease Patients

2013 ◽  
Vol 123 (3-4) ◽  
pp. 180-184 ◽  
Author(s):  
Eleni Ermeidi ◽  
Olga Balafa ◽  
Giorgos Spanos ◽  
Anastasia Zikou ◽  
Maria Argyropoulou ◽  
...  
Keyword(s):  
Renal Disease ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
End Stage Renal Disease ◽  
Posterior Reversible Encephalopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

scholarly journals Posterior Reversible Encephalopathy Syndrome in a Patient with Newly Diagnosed HIV Infection and End Stage Renal Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mohankumar Kurukumbi ◽  
Maria I. Castellanos ◽  
Amanda K. Crawford ◽  
Shreyas D. Gowdar ◽  
Annapurni Jayam-Trouth
Keyword(s):  
Endothelial Dysfunction ◽  
Renal Disease ◽  
Hiv Infection ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
End Stage Renal Disease ◽  
Vasogenic Edema ◽  
Posterior Reversible Encephalopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome in which patients present with an acute or subacute clinical presentation of seizures, visual disturbances, headache, and altered mental status. The pathophysiology of PRES may be explained by endothelial dysfunction that leads to transudation of fluids and protein, resulting in vasogenic cerebral edema. PRES is typically associated with many conditions such as hypertension, uremia, immunosuppressive drugs, and sepsis. This is a case report of a 39-year-old woman with untreated HIV infection and end-stage renal disease (ESRD) who developed PRES with a normal blood pressure and no other known causes of PRES. Untreated HIV is associated with known endothelial dysfunction and we believe that this, in combination with her untreated end-stage renal disease, contributed to her unique presentation of PRES. Although uncommon in HIV-infected patients and challenging to diagnose, prompt recognition of PRES is critical to provide appropriate care and ensure reversibility of the vasogenic edema seen in PRES.

scholarly journals Recurrent Posterior Reversible Encephalopathy Syndrome in an Adolescent Boy with End-Stage Renal Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Andrew Shieh ◽  
Natalie Darro
Keyword(s):  
Renal Disease ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
End Stage Renal Disease ◽  
Pediatric Care ◽  
Acute Glomerulonephritis ◽  
Posterior Reversible Encephalopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome, is a neurological entity characterized by acute change in consciousness, visual impairment, headache, and seizures. It is associated with autoimmune disease, immunosuppressive agents, organ transplantation, acute glomerulonephritis, and sepsis. Typically, vasogenic edema is seen in the white matter of parieto-occipital lobes but can also involve atypical locations such as frontal lobes, thalamus, basal ganglia, and gray matter. While occurring extensively in adults, few cases, especially recurrent episodes, have been described in children. We report a case of recurrent PRES in a 17-year-old boy with end-stage renal disease on a peritoneal dialysis program who initially presented with hypertension and seizures. He emergently received intravenous antihypertensive medication with immediate and sustained improvement in his mental status. Information about recurrent PRES in children is limited because it is not commonly seen. We examine the clinical features of PRES and highlight important points for the diagnosis and management of this rare syndrome. This report demonstrates the importance of pediatricians to consider PRES in the differential diagnosis in children presenting with acute altered mental status. Blood pressure measurements, which are often overlooked in pediatric care, may assist in correctly diagnosing patients.

scholarly journals Central-Variant Posterior Reversible Encephalopathy Syndrome with Albuminocytologic Dissociation

2018 ◽  
Vol 10 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Sang-Woo Lee ◽  
Seung-Jae Lee
Keyword(s):  
Blood Brain Barrier ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebral Hemispheres ◽  
Brain Barrier ◽  
Posterior Reversible Encephalopathy ◽  
Blood Brain ◽  
Normal White Blood Cell ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic brain edema which mainly involves the parieto-occipital lobes in various clinical settings. The main mechanism is known to be cerebral autoregulation failure and endothelial dysfunction leading to the disruption of the blood-brain barrier. We report the case of a 47-year-old woman with PRES which involved the brain stem and thalami, sparing the cerebral hemispheres. She was admitted to the emergency room because of acute-onset confusion. Her initial blood pressure was 270/220 mm Hg. Routine blood lab tests showed pleocytosis, hyperglycemia, and azotemia. Brain magnetic resonance imaging (MRI) showed a lesion of vasogenic edema involving nearly the whole area of pons, the left side of the midbrain, and the bilateral medial thalami. Cerebrospinal fluid (CSF) examination revealed an increased level of protein with normal white blood cell count. With conservative care, the patient markedly recovered 3 days after symptom onset, and a follow-up MRI confirmed complete resolution of the vasogenic edema. This case suggests that PRES can rarely involve the “central zone” only, sparing the cerebral hemispheres, which may be confused with other neurological diseases. Besides, the CSF albuminocytologic dissociation may suggest the disruption of the blood-brain barrier in patients with PRES.

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