A study on clinicoradiological characteristics and pregnancy outcomes of reversible posterior leukoencephalopathy syndrome in preeclampsia or eclampsia

Fang, Xiaobo; Liang, Yanling; Chen, Dunjin; He, Fang; Chen, Jia; Huang, Fami

doi:10.1038/hr.2017.76

Cited by 11 publications

(15 citation statements)

References 29 publications

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“…The average SLEDAI score could reach 26.3, and hormones were needed to increase to control the symptoms after the onset of PRES, which also support the above statement that the high activity of SLE is related to mortality, mainly because the high activity of SLE can lead to multiple organ diseases and increase the mortality rate. Previous literature reported that the incidence of PRES in pregnant patients can reach 0.22% [ 6 ]; this article found that pregnancy was the first cause of PRES, which is consistent with it. The proportion of pregnant patients in the death group was significantly less than that in the survival group; moreover, we confirmed that pregnancy was a protective factor for the death of PRES in multivariate analysis, showing that PRES in pregnant patients has the characteristics of high morbidity and low mortality, which is consistent with previous studies [ 5 , 6 , 8 ].…”

Section: Discussionsupporting

confidence: 84%

“…Similar to previous studies, most of the patients were young women [1][2][3][4][5][6][7][8], which is related to the specific disease states that PRES occurs in. This article found that pregnancy and SLE accounted for the first and second causes of PRES, respectively, 47.8% and 38.0%, which explains the age and gender characteristics of PRES.…”

Section: Discussionsupporting

confidence: 78%

“…Since Hinchey et al [1] first described PRES in 1996, the number of cases reported has gradually increased with the development of imaging technology. Previous studies have shown that SLE, kidney disease, autoimmune disease, pre-eclampsia/eclampsia, cytotoxic drug treatment, and other disease states are related with the occurrence of PRES [1][2][3][4][5][6]. Although PRES is mostly reversible, serious complications such as ischemia, bleeding, and death still occur [7,8].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Features and Risk Factors of Mortality in Patients with Posterior Reversible Encephalopathy Syndrome

Cui

Lei

Zhang

2022

Behavioural Neurology

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Objective. Although the prognosis of posterior reversible encephalopathy syndrome (PRES) is usually favourable and most patients wholly recover, the disorder can result in death in some patients. To date, the data on clinical features and risk factors for death are still lacking; therefore, we aim to investigate the clinical features and long-term prognostic risk factors of PRES in the present study. Methods. The patients with PRES were identified from the First Affiliated Hospital of Zhengzhou University from June 2011 to June 2020. Clinical characteristics, laboratory tests, magnetic resonance imaging examinations, and treatment of all patients were analyzed retrospectively. All patients were followed up by telephone. Finally, the patients were divided into the survival group and death group for prognosis analysis. Results. A total of 92 patients with PRES were included; 84.8% of whom were female, with an average age of 25.4 (5–66) years at the onset of PRES. Epilepsy was the main clinical manifestation (72.8%). The in-hospital mortality rate was 2.17%. The 3-year all-cause survival rate for PRES patients was 86%. In univariate analysis, patients with systemic lupus erythematosus ( P = 0.027 ) and blood transfusion history within 1 month before onset ( P = 0.027 ), need for dialysis ( P ≤ 0.001 ), nephritis ( P = 0.010 ), stroke ( P = 0.016 ), and heart failure ( P = 0.016 ) were associated with death. In multivariate analysis, we found that heart failure ( OR = 0.095 , 95% CI 0.020 to 0.441) and stroke ( OR = 0.033 , 95% CI 0.002 to 0.467) were independent risk factors for death in PRES patients, while pregnancy was a protective factor for death in PRES patients ( OR = 7.978 , 95% CI 1.446 to 44.006). Conclusions. Our results indicate that PRES could be considered as a sign of a very high-risk patient. We also demonstrated that heart failure and stroke were independent risk factors for death in patients with PRES; moreover, pregnancy was a protective factor.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Clinical Features and Risk Factors of Mortality in Patients with Posterior Reversible Encephalopathy Syndrome

Cui

Lei

Zhang

2022

Behavioural Neurology

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“…The risk factors of PE and eclampsia are to some extent the risk factors of PRLS, arising from physiological changes during pregnancy. 7 The results of this study found that, in the control group, the changes in systolic blood pressure and mean arterial pressure were more obvious ( P< 0.05). It suggested that, elevated blood pressure was an important factor in the formation of PRLS.…”

Section: Discussionmentioning

confidence: 62%

“…Therefore, Thl7 and Treg cells may be involved in embryo immune rejection and inflammation of pathological pregnancy such as PE. 2 …”

Section: Introductionmentioning

confidence: 99%

Expression Level of IL-17 in Peripheral Blood of Patients with Late Pregnancy and Diagnosis of Maternal-Fetal Tolerance Based on Brain MRI Image Segmentation Algorithm

Yu¹,

Zhou

Tan³

et al. 2021

Pak J Med Sci

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Objectives: To study the expression of IL-17 in peripheral blood and its effect on maternal-fetal tolerance in patients with eclampsia in late pregnancy using MRI image segmentation algorithm. Methods: Thirty-nine patients with severe preeclampsia and eclampsia with brain symptoms were examined by cranial MRI. Pregnant women with 32 weeks of pregnancy were selected to detect the percentage of Th17 and Treg cells in CD4 + T lymphocytes and the expression of cytokines IL-17 and IL-10 in peripheral blood. Results: MRI examination was normal in 26 cases, 9 cases showed reversible posterior encephalopathy syndrome, three cases were cerebral hemorrhage, and one case was intracranial cavernous sinus thrombosis. two. Compared with the mild preeclampsia group, the relative number of Thl7 cells increased and that of Treg cells decreased in the severe preeclampsia group (P>0.05). Conclusion: The major types of cerebrovascular diseases (CVD) in severe preeclampsia and eclampsia were reversible posterior encephalopathy syndrome and cerebral hemorrhage. It was speculated that the damage to the blood-brain barrier may play an important role in the pathogenesis. The balance of the number of Th17 cells/the number of Treg cells was more inclined to the Th17 cell-mediated pro-inflammatory state, Treg cell-mediated immune tolerance decreases, and it becomes more obvious with the worsening of the disease. doi: https://doi.org/10.12669/pjms.37.6-WIT.4828 How to cite this:Yu Z, Zhou S, Tan Z, Lu G. Expression Level of IL-17 in Peripheral Blood of Patients with Late Pregnancy and Diagnosis of Maternal-Fetal Tolerance Based on Brain MRI Image Segmentation Algorithm. Pak J Med Sci. 2021;37(6):1553-1557. doi: https://doi.org/10.12669/pjms.37.6-WIT.4828 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Serum Neurofilament Light: a Potential Diagnostic and Prognostic Biomarker in Obstetric Posterior Reversible Encephalopathy Syndrome

Fang

Liang

Zhang³

et al. 2021

Mol Neurobiol

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A study on clinicoradiological characteristics and pregnancy outcomes of reversible posterior leukoencephalopathy syndrome in preeclampsia or eclampsia

Cited by 11 publications

References 29 publications

Clinical Features and Risk Factors of Mortality in Patients with Posterior Reversible Encephalopathy Syndrome

Clinical Features and Risk Factors of Mortality in Patients with Posterior Reversible Encephalopathy Syndrome

Expression Level of IL-17 in Peripheral Blood of Patients with Late Pregnancy and Diagnosis of Maternal-Fetal Tolerance Based on Brain MRI Image Segmentation Algorithm

Serum Neurofilament Light: a Potential Diagnostic and Prognostic Biomarker in Obstetric Posterior Reversible Encephalopathy Syndrome

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