Posterior Reversible Encephalopathy Syndrome in a child with ulcerative colitis

2021 ◽  
Vol 75 (1) ◽  
pp. 46-50
Author(s):  
Eva Karásková ◽  
Mária Véghová-Velgáňová ◽  
Miloš Geryk ◽  
Vratislav Smolka ◽  
Kamila Michálková ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Arterial Hypertension ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Acute Onset ◽  
Posterior Reversible Encephalopathy ◽  
Parietal Lobes ◽  
Inflammatory Bowel ◽  
Magnetic Resonance Imaging Mri ◽  
High Intensity Signal ◽  
Reversible Encephalopathy

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical-neuroradiological entity with acute onset, defined as a vasogenic brain edema associated with neurotoxic impairment. We report the case of an eight-year-old boy with severe ulcerative colitis and celiac disease, who was treated with infliximab and azathioprine. On the 10th day after infliximab administration, a 45-minute unconsciousness developed with generalized convulsions and pupil miosis, accompanied by arterial hypertension. The boy was treated with anticonvulsants and antihypertensives. The state of consciousness improved ad integrum. Magnetic resonance imaging (MRI) of the brain revealed symmetric areas of high-intensity signal involving occipital and fronto-parietal lobes. Lumbar puncture was negative. Repeat MRI, seven days from the onset, showed resolution of the previous changes. The condition was assessed as PRES that developed as a complication of treatment (infliximab, azathioprine) in a patient with active ulcerative colitis. The case indicates a possible risk of developing PRES in patients with uncompensated inflammatory bowel disease, receiving immunosuppressive and/or bio­logical treatment and/or developing arterial hypertension

scholarly journals Posterior reversible encephalopathy syndrome associated with the use of chemotherapeutic agents: a rare complication after treatment with vinorelbine

2020 ◽  
Vol 13 (2) ◽  
pp. e229319 ◽  
Author(s):  
Ines Gil ◽  
Filipa Serrazina ◽  
Miguel Pinto ◽  
Miguel Viana-Baptista
Keyword(s):  
Blood Pressure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Grey Matter ◽  
Rare Complication ◽  
Chemotherapeutic Agents ◽  
Posterior Reversible Encephalopathy ◽  
Parietal Lobes ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

The posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterised by a combination of headache, encephalopathy, seizures and visual disturbances, associated with high-intensity abnormalities on T2-weighted images affecting subcortical white and grey matter of the occipital and parietal lobes. Among other causes, PRES has been associated with the use of several medications including chemotherapeutic agents. Here we report a case of a 65-year-old patient with squamous cell carcinoma of the lung treated with cisplatin/vinorelbine. Following the second administration of vinorelbine, she was admitted to the hospital for a generalised seizure. Blood pressure was just slightly elevated and, except for drowsiness, she had a near-normal neurological examination. MRI corroborated the diagnosis. Vinorelbine-induced PRES has been reported only once in the literature, also in association with cisplatin. Our case underlines the role of vinorelbine and suggests that its association with cisplatin in this setting may enhance the risk of PRES.

scholarly journals Eclampsia-Induced Posterior Reversible Encephalopathy Syndrome in a Donor Oocyte Recipient

2021 ◽  
Author(s):  
Jesús Garcia Castro ◽  
Jorge Rodríguez-Pardo ◽  
Javier Díaz de Terán
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Illustrative Case ◽  
Posterior Reversible Encephalopathy ◽  
Donor Oocyte ◽  
Oocyte Fertilization ◽  
Emergency Cesarean ◽  
Hypertensive Disorders In Pregnancy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Objective: Posterior reversible encephalopathy syndrome (PRES) has been robustly associated with preeclampsia, hyperperfusion or endothelial dysfunction suggested as possible mechanisms. In this article, we report an illustrative case of this complication in a patient with risk factors for hypertensive disorders in pregnancy, including advanced maternal age and donor oocyte fertilization. Case report: We present a case of a 40-year-old pregnant, donor oocyte recipient with sudden decreased visual acuity accompanied by hypertension, proteinuria and tonic-clonic seizures. Magnetic resonance imaging (MRI) of the brain showed bilateral lesions in the parieto-occipital regions suggestive of vasogenic edema, leading us to suspect posterior reversible encephalopathy syndrome. The patient underwent an emergency cesarean section and labetalol and magnesium sulfate were administered intravenously. The neurological symptoms and radiological findings resolved following delivery and the patient’s blood pressure normalized, supporting the diagnosis of posterior reversible encephalopathy syndrome. Conclusion: Pregnancy by donor oocyte fertilization may entail a higher risk of eclampsia and associated posterior reversible encephalopathy syndrome.  

scholarly journals Posterior Reversible Encephalopathy Syndrome in Pregnancy

2015 ◽  
Vol 7 (3) ◽  
pp. 205-206
Author(s):  
N Sundari ◽  
Asha Swaroop ◽  
BM Krupa ◽  
BK Madhusudhan ◽  
S Chaitra
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Acute Onset ◽  
Posterior Reversible Encephalopathy ◽  
Complete Reversal ◽  
The Common ◽  
T2 Hyperintensity ◽  
Reversible Encephalopathy ◽  
Visual Disturbances ◽  
In Pregnancy

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity characterized by several symptoms of varied etiologies. The common symptoms are headache, confusion, seizures, cortical visual disturbances or blindness. Here, we report a 22 years old lady with 32 weeks of gestation who presented with complaints of acute onset of headache, sudden loss of vision with elevated blood pressure (BP), whose magnetic resonance venogram (MR venogram) revealed bilateral occipital T2 hyperintensity with restriction of diffusion suggestive of PRES. Early identification and treatment usually results in complete reversal of the deficits and delayed diagnosis and improper management can lead to irreversible sequelae. How to cite this article Krupa BM, Sundari N, Madhusudhan BK, Swaroop A, Chaitra S. Posterior Reversible Encephalopathy Syndrome in Pregnancy. J South Asian Feder Obst Gynae 2015;7(3):205-206.

Steroid Sensitive Nephrotic Syndrome Presented as Posterior Reversible Encephalopathy Syndrome - A Rare Case Report

2020 ◽  
Vol 40 (2) ◽  
pp. 142-145
Author(s):  
Abhishek Abhinay ◽  
Jata Shankar ◽  
Sunil Kumar Rao ◽  
Om Prakash Mishra
Keyword(s):  
Nephrotic Syndrome ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Posterior Reversible Encephalopathy ◽  
Rare Case Report ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Adults And Children ◽  
Steroid Sensitive ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a rare serious syndrome of central nervous system that can develop in both adults and children. It is characterised by acute onset of headache, confusion, seizures, or focal neurological deficits along with radiological abnormalities in the parietal and occipital lobes. In the past, this syndrome has been mainly described in adults but rare in children. However, it is not uncommon in paediatric nephrology. Hypertension, renal disease, immunosuppression, and chemotherapy of malignancies are triggers for PRES. Here, we report a case of 12 years old boy with steroid-sensitive nephrotic syndrome presenting as PRES.

scholarly journals Posterior reversible encephalopathy syndrome mimicking cerebral metastasis: contraindication for biopsy

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Dukagjin Morina ◽  
Georgios Ntoulias ◽  
Homajoun Maslehaty ◽  
Martin Scholz ◽  
Athanasios K. Petridis
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Resonance Imaging ◽  
Open Biopsy ◽  
Posterior Reversible Encephalopathy ◽  
Typical Appearance ◽  
Magnetic Resonance Imaging Mri ◽  
Immunosupressive Therapy ◽  
Reversible Encephalopathy ◽  
Radiologic Features

The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient was treated for breast cancer 10 months ago and because of acute disorientation a magnetic resonance imaging (MRI) was performed. In the MRI biparieto-occipital hyperintense lesions were seen. Brain metastases were suspected. After chemothe - rapy and hypertonia and the typical appearance of the lesions in the MRI, PRES was also suspected. Before initializing the surgery for an open biopsy a follow-up MRI had been performed (2 weeks after initial MRI). In follow-up MRI the lesions disappeared completely proving the diagnosis of PRES. PRES can be misdiagnosed as a tumour and surgery could be mistakenly performed. It’s important to keep the differential diagnosis of PRES in mind when radiologic features of the syndrome are present.

Posterior Reversible Encephalopathy Syndrome

2019 ◽  
pp. 693-698
Author(s):  
Sudhir V. Datar ◽  
Jennifer E. Fugate
Keyword(s):  
Clinical Features ◽  
Cerebral Edema ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Acute Onset ◽  
Hypertensive Encephalopathy ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES), previously known as hypertensive encephalopathy, is a clinicoradiologic entity manifesting as acute onset of headache, encephalopathy, seizures, and vision abnormalities. The characteristic clinical features and predominantly posterior cerebral edema were first described by Hinchey and colleagues in 1996. Since then, many conditions have been associated with PRES.

scholarly journals Posterior Reversible Encephalopathy Syndrome following Ustekinumab Induction for Crohn’s Disease

2018 ◽  
Vol 12 (2) ◽  
pp. 521-527 ◽  
Author(s):  
Avantika Mishra ◽  
Darren N. Seril
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Human Monoclonal Antibody ◽  
Interleukin 12 ◽  
Cytokine Signaling ◽  
Acute Encephalopathy ◽  
Posterior Reversible Encephalopathy ◽  
Inflammatory Bowel ◽  
Reversible Encephalopathy

Biological agents are frequently used in the management of inflammatory bowel disease, and it is important to understand the potential adverse effects of these therapies. Ustekinumab is a human monoclonal antibody that interferes with interleukin-12 and -23 cytokine signaling and is approved for the treatment of moderate to severe Crohn’s disease. We report 2 cases of neurological adverse events, one of which is consistent with posterior reversible encephalopathy syndrome (PRES), in the setting of ustekinumab therapy for Crohn’s disease. The first patient had a seizure and classic neuroimaging features of PRES following induction with ustekinumab. The second patient presented with acute encephalopathy and atypical imaging findings concerning for PRES after ustekinumab induction. Both patients recovered fully following cessation of ustekinumab therapy. PRES associated with ustekinumab is uncommon, but must be a consideration in Crohn’s disease patients receiving this therapy who present with focal neurological symptoms or change in mentation.

scholarly journals Posterior Reversible Encephalopathy Syndrome in a Patient with Hemorrhagic Fever with Renal Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ermira Muco ◽  
Amela Hasa ◽  
Arben Rroji ◽  
Arta Kushi ◽  
Edmond Puca ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Supportive Therapy ◽  
Hemorrhagic Fever ◽  
Elisa Test ◽  
Albumin Level ◽  
Hantavirus Infection ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Physical Findings

We presently report the case of hantavirus infection in a 45-year-old male who was hospitalized to our clinic of infectious diseases, with fever, myalgia, vomiting, nausea, headache, and abdominal pain. The physical findings included hepatomegaly, splenomegaly, rash, and conjunctival injection. Eight days before the start of complaints, the patient has cut trees in the mountain. An acute renal failure was observed with an oliguria and an increase of serum creatinine and blood urea nitrogen. Urinalysis shows albuminuria and hematuria. Elevations of amylase, lipase, and liver enzymes levels, low serum albumin level, and thrombocytopenia were observed. A positive ELISA test for hantavirus IgM/IgG antibodies confirmed hemorrhagic fever with renal syndrome. On the third day of hospitalization, the patient had seizures. The unenhanced head computed tomography (CT) performed after seizures showed subcortical bilateral hypodensities within frontal, parietal, and occipital regions corresponding to areas of increased signal intensity in magnetic resonance imaging (MRI) associated with cerebral edema in posterior reversible encephalopathy syndrome (PRES). The treatment consisted of supportive therapy. The patient underwent another head MRI with contrast enhancement after 2 months, which resulted normal.

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