Determinants of Recovery from Severe Posterior Reversible Encephalopathy Syndrome

Legriel, Stéphane; Schraub, Olivier; Azoulay, Élie; Hantson, Philippe; Magalhaes, Eric; Coquet, Isaline; Bretonnière, Cédric; Gilhodes, Olivier; Anguel, Nadia; Mégarbane, Bruno; Benayoun, Laurent; Schnell, David; Plantefève, Gaëtan; Charpentier, Julien; Argaud, Laurent; Mourvillier, Bruno; Galbois, Arnaud; Chalumeau-Lemoine, Ludivine; Rivoal, Michel; Durand, François; Geffroy, Arnaud; Simón, Marc; Stoclin, Annabelle; Pallot, Judith; Arbelot, Charlotte; Nyunga, Martine; Lesieur, Olivier; Troché, Gilles; Bruneel, Fabrice; Cordoliani, Yves-Sébastien; Bédos, Jean‐Pierre; Pico, Fernando

doi:10.1371/journal.pone.0044534

Cited by 164 publications

(141 citation statements)

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“…We performed a systematic by posterior reversible encephalopathy syndrome, drug toxicity such as cyclosporine, betalactams and carbapenems, metabolic disorders, infectious causes and cerebral hemorrhages. 39,40 Life-sustaining therapies consisted of MV in 21-72%, noninvasive ventilation (NIV) in 28-40%, use of vasopressors in 47-68% and renal replacement therapy in 22-41%. 13,20,24,25,30,35 Diagnostic strategy Diagnostic strategy is crucial, as the absence of diagnosis is a key prognostic factor, particularly in ARF setting.…”

Section: Introductionmentioning

confidence: 99%

“…[52][53][54] Noninfectious causes of organ failure are usually diagnosed after exclusion of infections. They are mainly represented by cardiac edema, treatment toxicity, 39,40,[54][55][56][57][58][59][60][61][62][63] hemorrhages, GvHD, long-term allo-HSCT complications, 60,64 comorbidity decompensation and relapse. Several post-allograft complications can occur, but they do not all occur at any particular stage of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

Saillard

Blaise

Mokart

2016

Bone Marrow Transplant

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The outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients has significantly improved over the past decade. Still, a significant number of patients require intensive care unit (ICU) management because of life-threatening complications. Literature from the 1990s reported extremely poor prognosis for critically ill allo-HSCT patients requiring ICU management. Recent data justify the use of ICU resources in hematologic patients. Yet, allo-HSCT remains an independent variable associated with mortality. However, outcomes in allo-HSCT patients have improved over time and many classic determinants of mortality have become irrelevant. The main actual prognostic factors are the need for mechanical ventilation, the presence of GvHD and the number of organ failures at ICU admission. Recently, the development of reduced-intensity conditioning regimens, early ICU admission and the increased use of noninvasive ventilation, combined with time effect and general advances in hematology, in allo-HSCT procedures and in ICU management have contributed to improve general outcome. A rational policy of ICU admission triage in these patients is very hard to define, as each decision for ICU admission is a case-by-case decision at patient bedside. The collaboration between hematologists and intensivists is crucial in this context.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

Saillard

Blaise

Mokart

2016

Bone Marrow Transplant

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“…In a retrospective study of severe PRES, Legriel et al reported increased prevalence of status epilepticus and unfavorable functional outcome based on Glasgow Outcome Score [9]. Time to control of causative factor was found to be an independent predictor of 90 day functional outcome, highlighting the importance of recognition of clinical presentation and intervention [10,11].…”

Section: Discussionmentioning

confidence: 99%

Postoperative posterior reversible encephalopathy syndrome as initial presentation of systemic lupus erythematosus

Mehta¹

2018

Int J Case Rep Images

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. We present a case of a 25-year-old African-American woman with a history of chronic pelvic pain secondary to recurrent endometriosis presenting with chief complaints of fever and pelvic pain. She was treated with laparoscopic ablation three months prior. Workup revealed bilateral tuboovarian abscesses and the patient underwent total abdominal hysterectomy and bilateral salpingooophorectomy. Postoperatively, the patient had new onset hypertension which eventually lead to a seizure episode. The patient was transferred to the ICU, started on nicardipine and Keppra and her hypertension improved within several hours. Neuroimaging findings on MRI scan revealed lesions in the occipital and parietal lobes consistent with PRES. Outpatient workup conducted several months afterwards uncovered a diagnosis of systemic lupus erythematosus, leading us to conclude that the postoperative hypertensive emergency and PRES were secondary to undiagnosed SLE. IJCRI publishes Conclusion:The rare complication of PRES has been described in a variety of settings including SLE in which endothelial dysfunction of the intracerebral vasculature leads to characteristic PRES symptoms. Patients, especially those in the postoperative setting covered by multiple specialty providers, with new onset hypertension and neurological symptoms should warrant further workup as they may indicate underlying etiologies such as SLE or other described risk factors for PRES.

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“…La terminología del cuadro se fue modificando sobre la base del uso creciente de la resonancia magnética, y a la descripción clásica de lesiones típicas y reversibles hoy se agregan manifestaciones atípicas e irreversibles (Tabla 1). [1][2][3][4][5] Las enfermedades autoinmunes representan el 8%-45% de los casos. El lupus eritematoso sistémico (LES) es la principal patología asociada; [1][2][3]6,7 sin embargo, la asociación LES-EPR pediátrica es muy rara.…”

Section: Introductionunclassified

“…[1][2][3][4][5] Las enfermedades autoinmunes representan el 8%-45% de los casos. El lupus eritematoso sistémico (LES) es la principal patología asociada; [1][2][3]6,7 sin embargo, la asociación LES-EPR pediátrica es muy rara. 4,[6][7][8][9] Se describe una niña que presentó una EPR asociada a un LES, con evolución favorable, en la cual múltiples factores podrían haber contribuido a su desarrollo.…”

Section: Introductionunclassified

Encefalopatía reversible posterior en una niña con lupus eritematoso sistémico. Presentación de un caso

Marín¹

2015

Arch Argent Pediat

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Arch Argent Pediatr 2015;113(5):e271-e274 / e271Presentación de casos clínicos RESUMEN La encefalopatía posterior reversible es una patología de baja frecuencia en pediatría. Las manifestaciones clínicas características son cefaleas, convulsiones, trastornos visuales y de conciencia asociadas a imágenes típicas en la resonancia magnética del sistema nervioso. Por lo general, se manifiesta en pacientes con eclampsia, trasplante de órganos sólidos, enfermedades hematológicas, renales y autoinmunes, entre otras causas menos frecuentes, y suele desencadenarse luego de un cuadro de hipertensión arterial o el uso de drogas inmunosupresoras. Factores patogénicos menos habituales, como transfusión sanguínea, uso de inmunoglobulinas o una infección subyacente, pueden estar asociados. Se describe una paciente con lupus eritematoso sistémico, que desarrolló la encefalopatía al estar expuesta a múltiples factores etiopatogénicos. Palabras clave: síndrome de encefalopatía posterior reversible, lupus eritematoso sistémico, pediatría. ABSTRACTPosterior reversible encephalopathy is a rare disease in children. Clinical manifestations include headache, seizures, visual disturbances and altered consciousness associated with typical magnetic resonance images of the nervous system. The syndrome usually manifests in patients with eclampsia, solid organ transplantation, haematologic, renal and autoimmune diseases among other less common causes and it is often triggered after a hypertensive crisis or use of immunosuppressive drugs. Less common pathogenic factors as blood transfusion, use of immunoglobulins or an underlying infection can be associated. In this case a girl with systemic lupus erythematosus and exposed to multiple etiopathogenic factors developed posterior reversible encephalopathy.

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Determinants of Recovery from Severe Posterior Reversible Encephalopathy Syndrome

Cited by 164 publications

References 42 publications

Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

Postoperative posterior reversible encephalopathy syndrome as initial presentation of systemic lupus erythematosus

Encefalopatía reversible posterior en una niña con lupus eritematoso sistémico. Presentación de un caso

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