Posterior Reversible Encephalopathy and Cerebral Vasoconstriction in a Patient With Hemolytic Uremic Syndrome

Agarwal, Rashmi; Davis, Cresha; Altınok, Deniz; Serajee, Fatema J.

doi:10.1016/j.pediatrneurol.2014.01.024

Cited by 20 publications

(10 citation statements)

References 15 publications

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“…The underlying pathology of visual disturbances in HUS is similar to that seen in posterior reversible encephalopathy syndrome (PRES). 25 It was observed in two (8.3%) patients in our study. In another study, visual symptoms were observed in 30% of patients with neurological involvement.…”

Section: Discussionsupporting

confidence: 44%

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

et al. 2017

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Background Neurological involvement is common in hemolytic uremic syndrome (HUS), but each neurological symptom may be due to a variety of factors. Objective We aimed to evaluate predisposing factors to the neurological symptoms in HUS. Materials and Methods The 10-year follow-up data on HUS patients were retrospectively analyzed. Statistical comparisons were made across subgroups based on age and neurological symptoms. Results The neurological involvement rate was 37.5%. The female-to-male ratio increased in patients with neurological involvement (3.8 vs. 1.37). Regarding all HUS patients, hemoglobin levels were higher in patients with paresis. The rate of paresis was twofold higher in patients with a hemoglobin level above 11 g/dL (p < 0.05). In diarrhea-associated HUS patients, D-dimer and C-reactive protein levels were higher in patients with paresis, and leukocyte counts were higher in patients with seizures. Patients with altered consciousness had higher creatinine levels. The survival rate was significantly lower in patients with a reticulocyte percentage of less than 2% (50 vs. 100%). Conclusion Results of our study indicate that neurological involvement depends on overall findings in HUS. A symptom-oriented approach, which is different from that employed in previous studies, reveals some clues to the pathogenesis and management of these patients.

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Section: Discussionsupporting

confidence: 44%

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

et al. 2017

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“…44 Furthermore, PRES and RCVS often arise concurrently as complications of various medical conditions, including intravenous immunoglobin therapy, Guillain-Barre syndrome, immunosuppression, stem cell transplantation, blood transfusions, and septic shock. 2,7,28,54,56,66,67 Finally, both PRES and RCVS demonstrate similar clinical features, including an acute, self-limited course and symptomatology, such as headache, confusion, seizure, and transient or permanent neurologic deficits. 1,2,54 Given the significant overlap between the 2 entities, it is possible that RCVS and PRES may represent a spectrum of potential clinical manifestations of a common underlying pathophysiology involving various degrees of altered cerebral vascular tone and endothelial dysfunction.…”

Section: Association With Presmentioning

confidence: 97%

Reversible Cerebral Vasoconstriction Syndrome, Part 1: Epidemiology, Pathogenesis, and Clinical Course

Miller

Shivashankar

Mossa‐Basha

et al. 2015

AJNR Am J Neuroradiol

205

194

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SUMMARY:Reversible cerebral vasoconstriction syndrome is a clinical and radiologic syndrome that represents a common presentation of a diverse group of disorders. The syndrome is characterized by thunderclap headache and reversible vasoconstriction of cerebral arteries, which can either be spontaneous or related to an exogenous trigger. The pathophysiology of reversible cerebral vasoconstriction syndrome is unknown, though alterations in cerebral vascular tone are thought to be a key underlying mechanism. The syndrome typically follows a benign course; however, reversible cerebral vasoconstriction syndrome may result in permanent disability or death in a small minority of patients secondary to complications such as ischemic stroke or intracranial hemorrhage.ABBREVIATIONS: RCVS ϭ reversible cerebral vasoconstriction syndrome; PRES ϭ posterior reversible encephalopathy syndrome

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“…To the best of our knowledge, the co-occurrences of RCVS and PRES have been reported in the following conditions, such as postpartum, post-transfusion, intracranial hypotension, licorice and hemolytic uremic syndrome. The co-occurrences have also found after bilateral carotid paraganglioma resection, oral contraceptive pills intravenous immune globulin therapy in Guillain-Barre syndrome and heart transplantation [7,[12][13][14][15][16][17][18][19][20][21]. The pathogenesis of RCVS or PRES has been poorly understood, however, autonomic dysregulation, oxidative stress, and genetic predisposition are postulated [1].…”

Section: Discussionmentioning

confidence: 99%

Reversible cerebral vasoconstriction syndrome presenting as convexity subarachnoid haemorrhage and posterior reversible encephalopathy syndrome during postpartum: a case report and literature review

Yuan

Jia

Wei

2019

Preprint

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Background Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headache and reversible cerebral vasoconstriction, with other neurologic signs and symptoms. To the best of our knowledge, there were only a few cases of RCVS presenting both as both convexity subarachnoid haemorrhage (cSAH) and posterior reversible encephalopathy syndrome (PRES). Case presentation Herein, We report a case of a 32-year-old woman with RCVS who presented with recurrent thunderclap headaches that occurred 50 days after delivery, with cSAH and PRES on magnetic resonance imaging (MRI). She had significant clinical and radiological recover with 3 months’ follow-up. Conclusions The clinical coexistence of cSAH and PRES in our case with RCVS is quite rare. This case further raises the importance of the early diagnosis of RCVS, and clinical physicians should be well recognized when initial brain and vascular imaging are normal.

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Posterior Reversible Encephalopathy and Cerebral Vasoconstriction in a Patient With Hemolytic Uremic Syndrome

Cited by 20 publications

References 15 publications

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

Reversible Cerebral Vasoconstriction Syndrome, Part 1: Epidemiology, Pathogenesis, and Clinical Course

Reversible cerebral vasoconstriction syndrome presenting as convexity subarachnoid haemorrhage and posterior reversible encephalopathy syndrome during postpartum: a case report and literature review

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