Posterior reversible encephalopathy syndrome secondary to eclampsia

Amagada, J O; Kondagunta, H; Afshan, Nida; Watermeyer, S; Jones, Rod

doi:10.1080/01443610802378264

Cited by 10 publications

(3 citation statements)

References 9 publications

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“…The spectrum of cerebral lesions in eclampsia seen with MRI varies from initially reversible areas of vasogenic edema to those that may progress to cytotoxic edema and infarction in up to a fourth of women. Eclamptic seizures might be considered as one of the symtoms of PRES in severely preeclamptic patients (20,21). In the present severe preeclamptic case, sensory and motor deficits rather than seizure developed as the manifestations of PRES, which is an atypical presentation.…”

Section: Discussionmentioning

confidence: 82%

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Aygün¹,

Baykuş²,

Berilgen³

et al. 2010

J Turkish German Gynecol Assoc

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ÖzetWe describe a 23 year old primigravid patient with severe preeclampsia complicated by posterior reversible encephalopathy syndrome (PRES), who presented with sensory and motor deficits and amnesia in the postpartum period Cranial magnetic resonance imaging (MRI) showed abnormal areas in the white matter of bilateral parieto-occipital lobes, indicating brain edema which disappeared completely on the follow-up scan taken four weeks after delivery together with complete symptom regression. The development of PRES in preeclampsia is discussed and the importance of prompt postpartum blood pressure control is emphasized.(J Turkish-German Gynecol Assoc 2010; 11: 216-9) Bu yazıda 23 yaşında, ilk gebeliği olan şiddetli preeklamptik bir hastada postpartum dönemde duyusal ve motor sinir bulguları ve unutkanlık ile ortaya çıkan bir posterior reverzibl ensefalopati sendromu (PRES) sunulmuştur. Kranyal manyetik rezonans görüntüleme (MRI) ile bilateral parieto-occipital loblarda beyin ödemine işaret eden anormal alanlar görülmüş olup, doğumdan dört hafta sonra kontrol amaçlı yapılan görüntüleme testi ile bu lezyonların tamamen kaybolduğu ve semptomların da gerilediği tespit edilmiştir. Preeklampside PRES gelişimi tartışılarak, bu hastalarda postpartum kan basıncı kontrolünün önemi vurgulanmıştır.

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Section: Discussionmentioning

confidence: 82%

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Aygün¹,

Baykuş²,

Berilgen³

et al. 2010

J Turkish German Gynecol Assoc

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“…Settings in Which PRES May Be Likely to Develop Autoimmune disorders: Systemic Lupus Erythematous, antiphospholipid syndrome, polyarteritis nodosa, cryoglobulinemia, thrombotic thrombocytopenic purpura, scleroderma, polyangiitis, antiglomerular basement membrane antibody disease, rheumatoid arthritis, Sjögren syndrome, Crohn's disease, ulcerative colitis, autoimmune hepatitis, type 1 diabetes mellitus, Grave's disease, Hashimoto thyroiditis, and neuromyelitis optica [2, 16–20]Essential hypertensionPreeclampsia and eclampsia [21, 22]Acute or chronic renal failure and dialysis (55%)[23–27]Septicemia and severe infections (predominantly gram positive organisms) [4, 28]Immunosuppressive therapy (despite normal levels): cisplatin, cyclosporine, tacrolimus, intravenous globulin, rituximab, methotrexate, bevacizumab, sunitinib, and sorafenib [15, 29–33]Others: blood transfusion, contrast exposure, hypercalcemia, cocaine, and methamphetamineThe incidence has been variably reported, with a study from Ireland showing an occurrence of 0.84% [34]. Patients with CKD and end stage renal disease (ESRD) have the perfect setup for the development of PRES such as a higher MAP, volume overload, electrolyte abnormalities, and underlying chronic vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury, Recurrent Seizures, and Thrombocytopenia in a Young Patient with Lupus Nephritis: A Diagnostic Dilemma

Verduzco

Acharya

2016

Case Reports in Nephrology

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Introduction. Posterior reversible encephalopathy syndrome (PRES) is a constellation of clinical and radiologic findings. Fluctuations in blood pressure, seizures, and reversible brain MRI findings mainly in posterior cerebral white matter are the main manifestations. PRES has been associated with multiple conditions such as autoimmune disorders, pregnancy, organ transplant, and thrombotic microangiopathy (TMA). Case Presentation. A 22-year-old woman with history of Systemic Lupus Erythematous complicated with chronic kidney disease secondary to lupus nephritis class IV presented with recurrent seizures and uncontrolled hypertension. She was found to have acute kidney injury and thrombocytopenia. Repeat kidney biopsy showed diffuse endocapillary and extracapillary proliferative and membranous lupus nephritis (ISN-RPS class IV-G+V) and endothelial swelling secondary to severe hypertension but no evidence of TMA. Brain MRI showed reversible left frontal and parietal lesions that resolved after controlling the blood pressure, making PRES the diagnosis. Conclusion. PRES is an important entity that must be recognized and treated early due to the potential reversibility in the early stages. Physicians must have high suspicion for these unusual presentations. We present a case where performing kidney biopsy clinched the diagnosis in our patient with multiple confounding factors.

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“…The focus of management is aggressive blood pressure control and standard treatment of preeclampsia/eclampsia. 48 Postpartum Headache -The postpartum period is characterized by sleep deprivation, hormonal changes, irregular food intake, psychological stress, and fatigue. One group retrospectively reported their experience with 95 women with postpartum headache, defined as the onset of severe unrelenting headache greater than 24 hours and less than 42 days from the time of delivery.…”

Section: Neuroimaging Studies Are Indicated In Women With a Severe Hementioning

confidence: 99%

Headache in pregnancy: Recent insight

Rahman

Islam

Habib

et al. 2013

Bangladesh Crit Care J

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Posterior reversible encephalopathy syndrome secondary to eclampsia

Cited by 10 publications

References 9 publications

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Acute Kidney Injury, Recurrent Seizures, and Thrombocytopenia in a Young Patient with Lupus Nephritis: A Diagnostic Dilemma

Headache in pregnancy: Recent insight

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