后可逆性脑病综合征,在肾脏受累的儿科患者中并不罕见:病例系列。

Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI:10.2478/jccm-2024-0004
Ana-Maria Roxana Koller, Alexandra Man, Carmen Muntean
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引用次数: 0

摘要

前言后可逆性脑病综合征(PRES)主要表现为神经系统症状,多见于男性,常发生于肿瘤患者。它还可能与链球菌感染后肾小球肾炎等肾脏疾病有关,而肾小球肾炎是小儿高血压的常见病因。治疗包括降压和癫痫治疗。在某些情况下,它可能会导致不可逆转的严重并发症。早期治疗对预防至关重要:在过去的六个月中,我们记录了两名患者的病例,他们的年龄分别为 15 岁和 10 岁,均伴有 PRES 和肾病。这两名患者因全身不适、头痛、恶心、呕吐、视力障碍和血压升高而入院。随后,两名患者都出现了癫痫发作。只有第一名患者需要转入儿科重症监护室(PICU)。脑磁共振成像(MRI)扫描显示,两例患者均有明显的 PRES 病变。经过全面检查,两例患者均被诊断为链球菌感染后急性肾小球肾炎中的PRES:结论:在服用降压药和抗惊厥药以及治疗潜在的肾病后,患者的病情有所好转。
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Posterior Reversible Encephalopathy Syndrome, not so Uncommon in Pediatric Patients with Renal Involvement: A Case Series.

Introduction: Posterior reversible encephalopathy syndrome (PRES) primarily shows neurological symptoms and is more frequent in males, often occurring in oncological patients. It can also be associated with renal conditions like post-streptococcal glomerulonephritis, a common cause of pediatric hypertension. Management involves blood pressure and seizure treatment. In some cases, it may lead to irreversible and severe complications. Early treatment is essential for prevention.

Presentation of case series: In the past six months, we have documented the cases of two patients, aged 15 and 10, both of whom presented with PRES and renal disease. These patients were admitted because of general malaise, headaches, nausea, vomiting, visual disturbances, and elevated blood pressure. Subsequently, both patients experienced epileptic episodes. Only the first patient required transfer to the Pediatric Intensive Care Unit (PICU). Cerebral magnetic resonance imaging (MRI) scans revealed distinct PRES lesions in both cases. Following comprehensive investigations, both cases were diagnosed with PRES in the context of acute post-streptococcal glomerulonephritis.

Conclusions: The patients showed improvement following the administration of antihypertensive and anticonvulsant medications, along with treatment for the underlying renal condition.

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