Patterns, risk factors and outcome predictors of posterior reversible encephalopathy syndrome in pediatric cancer patients

Hafez, Hanafy; Ragab, Iman; Sedky, Mohamed; Shams, Marwa; Youssef, Ayda; Refaat, Amal; Habib, Elsaeed; Sidhom, Iman

doi:10.1080/10428194.2020.1832658

Cited by 8 publications

(17 citation statements)

References 34 publications

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“…The review of the literature ultimately yielded 21 PRES articles ( 11 , 12 , 15 , 18 , 24 – 26 , 28 , 31 , 36 – 46 ) comprising a total of 440 pediatric PRES patients with hematologic/oncologic diseases, which were included in the meta-analysis along with the data of the 20 PRES patients from the present study ( Supplementary Table 1 and Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Hypertension is more common in children than in adults with PRES ( 106 ). Between 67 and 100% of patients with PRES have hypertension after undergoing HSCT or receiving chemotherapy in pediatric oncologic/hematological diseases ( 10 – 13 , 15 , 24 – 28 , 36 , 40 , 46 , 56 , 57 , 105 , 107 , 108 ). In our systematic review, the rate of hypertension was higher after HSCT than after chemotherapy (75.0 vs. 51.0%) in pediatric patients with oncologic/hematologic diseases and PRES; we previously showed that hypertension leads to a poor outcome in this group ( 10 ) ( Figure 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…A previous retrospective study found that mechanical ventilation was required in 71% of adult patients with severe PRES; the mortality rate attributed to PRES was 5.7%, with toxicity (44%) and hypertensive encephalopathy (41%) being the main causes of death ( 47 ). In pediatric patients with oncologic/hematologic diseases, early diagnosis of PRES is critical for avoiding neurologic sequelae and death ( 10 – 12 , 15 , 17 , 19 , 24 , 32 , 105 , 111 ). PRES in children is more common in hematologic diseases compared to other malignancies and is associated with hypertension, infection, and steroid use; seizures are the most common acute manifestation.…”

Section: Discussionmentioning

confidence: 99%

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Management and Clinical Outcome of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncologic/Hematologic Diseases: A PRES Subgroup Analysis With a Large Sample Size

et al. 2021

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This study investigated the management and clinical outcomes along with associated factors of posterior reversible encephalopathy syndrome (PRES) in childhood hematologic/oncologic diseases. We present data from children with hematologic/oncologic diseases who developed PRES after treatment of the primary disease with chemotherapy and hematopoietic stem cell transplantation (HSCT) at 3 medical centers in Changsha, China from 2015 to 2020, and review all previously reported cases with the aim of determining whether this neurologic manifestation affects the disease prognosis. In the clinical cohort of 58 PRES patients, hypertension [pooled odds ratio (OR) = 4.941, 95% confidence interval (CI): 1.390, 17.570; P = 0.001] and blood transfusion (OR = 14.259, 95% CI: 3.273, 62.131; P = 0.001) were significantly associated with PRES. Elevated platelet (OR = 0.988, 95% CI: 0.982, 0.995; P < 0.001), hemoglobin (OR = 0.924, 95% CI: 0.890, 0.995; P < 0.001), and blood sodium (OR = 0.905, 95% CI: 0.860, 0.953; P < 0.001), potassium (OR = 0.599, 95% CI: 0.360, 0.995; P = 0.048), and magnesium (OR = 0.093, 95% CI: 0.016, 0.539; P = 0.008) were protective factors against PRES. Data for 440 pediatric PRES patients with hematologic/oncologic diseases in 21 articles retrieved from PubMed, Web of Science, and Embase databases and the 20 PRES patients from our study were analyzed. The median age at presentation was 7.9 years. The most common primary diagnosis was leukemia (62.3%), followed by solid tumor (7.7%) and lymphoma (7.5%). Most patients (65.0%) received chemotherapy, including non-induction (55.2%) and induction (44.8%) regimens; and 86.5% used corticosteroids before the onset of PRES. Although 21.0% of patients died during follow-up, in most cases (93.2%) this was not attributable to PRES but to severe infection (27.3%), underlying disease (26.1%), graft-vs.-host disease (14.8%), multiple organ dysfunction syndrome (8.0%), and respiratory failure (3.4%). PRES was more common with HSCT compared to chemotherapy and had a nearly 2 times higher mortality rate in patients with oncologic/hematologic diseases than in those with other types of disease. Monitoring neurologic signs and symptoms in the former group is therefore critical for ensuring good clinical outcomes following treatment of the primary malignancy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management and Clinical Outcome of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncologic/Hematologic Diseases: A PRES Subgroup Analysis With a Large Sample Size

et al. 2021

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“…In the largest population-based cohort study, the mean age at presentation is 12.54±0.19 years, which shows PRES is more common in adolescent groups. Females are more prone to have PRES than males (9,10) .…”

Section: Discussionmentioning

confidence: 96%

“…The most common type of malignancy to cause PRES is ALL then lymphoma and acute myeloid leukemia ( 10) . Majority of the cases show symptoms within 6 months and mostly first month after start of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome During Acute Lymphoblastic Leukemia Treatment

Atamyıldız¹,

Ataseven²,

Eraslan³

et al. 2021

Terh

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Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological syndrome, characterized by acute onset of headache, altered mental status, visual impairment, nausea, vomiting, seizure, and hypertension. PRES is a reversible condition if it is recognized early, but neurological damage or even death may occur. Herein, we present two cases of ALL who developed PRES during their induction therapy and a literature review of PRES.

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Pediatric posterior reversible encephalopathy syndrome: Can MR imaging features predict outcomes in non-oncologic patients?

Nada,

Libda,

Gohary

et al. 2024

European Journal of Radiology

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Patterns, risk factors and outcome predictors of posterior reversible encephalopathy syndrome in pediatric cancer patients

Cited by 8 publications

References 34 publications

Management and Clinical Outcome of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncologic/Hematologic Diseases: A PRES Subgroup Analysis With a Large Sample Size

Management and Clinical Outcome of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncologic/Hematologic Diseases: A PRES Subgroup Analysis With a Large Sample Size

Posterior Reversible Encephalopathy Syndrome During Acute Lymphoblastic Leukemia Treatment

Pediatric posterior reversible encephalopathy syndrome: Can MR imaging features predict outcomes in non-oncologic patients?

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