Reversible posterior encephalopathy syndrome in a 10-year-old child

Detalhes bibliográficos
Autor(a) principal: Carvalho,Eve Grillo
Data de Publicação: 2019
Outros Autores: Peluso,Henrique Guarino Colli, Batista,Lorena Luana, Moreira,Cissa Santos, Protti,Juliana Suzano Moraes, Soares,Maria Cristina Bento, Autran,Aline de Freitas Suassuna, Almeida,Amanda Rocha Soares, Rodrigues,Denise Cristina, Bernardes,Lívia Verônica Grillo Romano, Paula,Luciana Pimenta de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300436
Resumo: Abstract Introduction: The posterior reversible encephalopathy (PRES) syndrome encompasses a set of clinical-radiological findings associated with severe systemic arterial hypertension. This case report proposes to discuss the identification, diagnosis, and management of PRES in the pediatric population. Case presentation: Female patient, 10 years old, admitted to the emergency room with complaint of oliguria and generalized edema. At the initial physical exam, the only alteration present was anasarca. The diagnostic investigation revealed nephrotic syndrome, and clinical treatment was started. She evolved on the 8th day of hospitalization with peak hypertension, sudden visual loss, reduced level of consciousness, nystagmus, and focal seizures requiring intubation. She was transferred to the Intensive Care Unit, with neurological improvement, after the established therapy. CT scan revealed a discrete hypodense area in the white matter of the occipital lobe and anteroposterior groove asymmetry, compatible with PRES. Discussion: PRES is due to vasogenic cerebral edema of acute or subacute installation. Symptoms include headache and altered consciousness, stupor, coma, neurological deficits, seizures and cortical blindness. Nephropathies are the main cause of PRES in pediatrics. Magnetic resonance imaging with diffusion of molecules is the gold standard for diagnosis. The initial treatment objectives are the reduction of blood pressure, antiepileptic therapy, correction of hydroelectrolytic and acid-base disorders and management of intracranial hypertension. Conclusion: PRES is associated with acute hypertension. Early diagnosis and proper management may determine a better prognosis and minimize the severity of the clinical course.
id SBN-1_16ba981226ea5974bd43e68420c43102
oai_identifier_str oai:scielo:S0101-28002019000300436
network_acronym_str SBN-1
network_name_str Jornal Brasileiro de Nefrologia
repository_id_str
spelling Reversible posterior encephalopathy syndrome in a 10-year-old childPosterior Leukoencephalopathy SyndromePediatricsNephrologyNeurologyAbstract Introduction: The posterior reversible encephalopathy (PRES) syndrome encompasses a set of clinical-radiological findings associated with severe systemic arterial hypertension. This case report proposes to discuss the identification, diagnosis, and management of PRES in the pediatric population. Case presentation: Female patient, 10 years old, admitted to the emergency room with complaint of oliguria and generalized edema. At the initial physical exam, the only alteration present was anasarca. The diagnostic investigation revealed nephrotic syndrome, and clinical treatment was started. She evolved on the 8th day of hospitalization with peak hypertension, sudden visual loss, reduced level of consciousness, nystagmus, and focal seizures requiring intubation. She was transferred to the Intensive Care Unit, with neurological improvement, after the established therapy. CT scan revealed a discrete hypodense area in the white matter of the occipital lobe and anteroposterior groove asymmetry, compatible with PRES. Discussion: PRES is due to vasogenic cerebral edema of acute or subacute installation. Symptoms include headache and altered consciousness, stupor, coma, neurological deficits, seizures and cortical blindness. Nephropathies are the main cause of PRES in pediatrics. Magnetic resonance imaging with diffusion of molecules is the gold standard for diagnosis. The initial treatment objectives are the reduction of blood pressure, antiepileptic therapy, correction of hydroelectrolytic and acid-base disorders and management of intracranial hypertension. Conclusion: PRES is associated with acute hypertension. Early diagnosis and proper management may determine a better prognosis and minimize the severity of the clinical course.Sociedade Brasileira de Nefrologia2019-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300436Brazilian Journal of Nephrology v.41 n.3 2019reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2018-0111info:eu-repo/semantics/openAccessCarvalho,Eve GrilloPeluso,Henrique Guarino ColliBatista,Lorena LuanaMoreira,Cissa SantosProtti,Juliana Suzano MoraesSoares,Maria Cristina BentoAutran,Aline de Freitas SuassunaAlmeida,Amanda Rocha SoaresRodrigues,Denise CristinaBernardes,Lívia Verônica Grillo RomanoPaula,Luciana Pimenta deeng2019-09-24T00:00:00Zoai:scielo:S0101-28002019000300436Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2019-09-24T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv Reversible posterior encephalopathy syndrome in a 10-year-old child
title Reversible posterior encephalopathy syndrome in a 10-year-old child
spellingShingle Reversible posterior encephalopathy syndrome in a 10-year-old child
Carvalho,Eve Grillo
Posterior Leukoencephalopathy Syndrome
Pediatrics
Nephrology
Neurology
title_short Reversible posterior encephalopathy syndrome in a 10-year-old child
title_full Reversible posterior encephalopathy syndrome in a 10-year-old child
title_fullStr Reversible posterior encephalopathy syndrome in a 10-year-old child
title_full_unstemmed Reversible posterior encephalopathy syndrome in a 10-year-old child
title_sort Reversible posterior encephalopathy syndrome in a 10-year-old child
author Carvalho,Eve Grillo
author_facet Carvalho,Eve Grillo
Peluso,Henrique Guarino Colli
Batista,Lorena Luana
Moreira,Cissa Santos
Protti,Juliana Suzano Moraes
Soares,Maria Cristina Bento
Autran,Aline de Freitas Suassuna
Almeida,Amanda Rocha Soares
Rodrigues,Denise Cristina
Bernardes,Lívia Verônica Grillo Romano
Paula,Luciana Pimenta de
author_role author
author2 Peluso,Henrique Guarino Colli
Batista,Lorena Luana
Moreira,Cissa Santos
Protti,Juliana Suzano Moraes
Soares,Maria Cristina Bento
Autran,Aline de Freitas Suassuna
Almeida,Amanda Rocha Soares
Rodrigues,Denise Cristina
Bernardes,Lívia Verônica Grillo Romano
Paula,Luciana Pimenta de
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Carvalho,Eve Grillo
Peluso,Henrique Guarino Colli
Batista,Lorena Luana
Moreira,Cissa Santos
Protti,Juliana Suzano Moraes
Soares,Maria Cristina Bento
Autran,Aline de Freitas Suassuna
Almeida,Amanda Rocha Soares
Rodrigues,Denise Cristina
Bernardes,Lívia Verônica Grillo Romano
Paula,Luciana Pimenta de
dc.subject.por.fl_str_mv Posterior Leukoencephalopathy Syndrome
Pediatrics
Nephrology
Neurology
topic Posterior Leukoencephalopathy Syndrome
Pediatrics
Nephrology
Neurology
description Abstract Introduction: The posterior reversible encephalopathy (PRES) syndrome encompasses a set of clinical-radiological findings associated with severe systemic arterial hypertension. This case report proposes to discuss the identification, diagnosis, and management of PRES in the pediatric population. Case presentation: Female patient, 10 years old, admitted to the emergency room with complaint of oliguria and generalized edema. At the initial physical exam, the only alteration present was anasarca. The diagnostic investigation revealed nephrotic syndrome, and clinical treatment was started. She evolved on the 8th day of hospitalization with peak hypertension, sudden visual loss, reduced level of consciousness, nystagmus, and focal seizures requiring intubation. She was transferred to the Intensive Care Unit, with neurological improvement, after the established therapy. CT scan revealed a discrete hypodense area in the white matter of the occipital lobe and anteroposterior groove asymmetry, compatible with PRES. Discussion: PRES is due to vasogenic cerebral edema of acute or subacute installation. Symptoms include headache and altered consciousness, stupor, coma, neurological deficits, seizures and cortical blindness. Nephropathies are the main cause of PRES in pediatrics. Magnetic resonance imaging with diffusion of molecules is the gold standard for diagnosis. The initial treatment objectives are the reduction of blood pressure, antiepileptic therapy, correction of hydroelectrolytic and acid-base disorders and management of intracranial hypertension. Conclusion: PRES is associated with acute hypertension. Early diagnosis and proper management may determine a better prognosis and minimize the severity of the clinical course.
publishDate 2019
dc.date.none.fl_str_mv 2019-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300436
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300436
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2018-0111
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.41 n.3 2019
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
_version_ 1752122065520951296