ESPN 51th Annual Meeting

ESPN 2018


 
Posterior Reversible Encephalopathy Syndrome in Kidney Disease: Case Series
DEMET ALAYGUT 1 CANER ALPARSLAN 1 FATMA MUTLUBAŞ 1 EREN SOYALTIN 1 FULYA KAMIT CAN 2 AYSE BERNA ANIL 3 SEÇIL ARSLANSOYU ÇAMLAR 1 ONDER YAVASCAN 1 BELDE KASAP DEMIR 4

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRIC INTENSIVE CARE UNIT
3- IZMIR KATIP CELEBI UNIVERSITY DEPARTMENT OF PEDIATRIC INTENSIVE CARE
4- IZMIR KATIP CELEBI UNIVERSITY DEPARTMENT OF PEDIATRIC NEPHROLOGY AND RHEUMATOLOGY
 
Introduction:

 Posterior reversible encephalopathy syndrome (PRES) is a pathology defined in 1990s and it is thought that the underlying mechanism is vasogenic edema. PRES can be seen with kidney disease, rheumatological diseases, hematological disorders, solid and humoral organ transplants and whose frequency is unknown in children. In this report, it was shared experience with 6 PRES cases .

Material and methods:

 Cases: There were 6 cases.  Five of cases were male. The mean age of the patients was 13.66 (min 9, max 21) years. Two of the cases were rapidly progressive renal disease and the others diagnosis revealed different underlying disorders. Before the development of PRES, only one patients blood pressure measurements were observed at normal limits. At least one immunosuppressive medication was available in half of the patients. Five patients with various neurological findings had the same  seizure activity. In cranial magnetic resonance imaging, occipital area was affected often . 

Results:

Common treatment management was performed with intravenous antihypertensive drugs except that pulse steroid treatment was discontinued in case 1. It was seen that renal diseases were regressed in short-term follow-ups of patients except for a patient with lymphohistiocytosis  and disseminated intravascular coagulation  (case 3). Similarly, no neurological sequelae were detected in any case.

Conclusions:

 PRES is associated with various diseases in pediatric nephrology practice. We think that it is useful to keep PRES in mind especially in the neurological findings after sudden increases in blood pressure and to request cranial MR imaging examination in order to make differential diagnosis rapidly.