Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report
ABSTRACT Introduction: Posterior reversible leukoencephalopathy syndrome (PRES) was first described by Hinchey in 1996. The syndrome is characterized by altered level of consciousness, headache, visual changes, and seizures associated with a vasogenic edema of the white matter that occurs predominantly in the occipital and parietal lobes. Imaging tests such as computed tomography (CT) and especially magnetic resonance imaging (MRI) support the diagnosis. Case Report: We report a case of a 48-year-old female patient who underwent a deceased donor kidney transplant and received tacrolimus as a part of the immunosuppressive regimen. Five weeks after transplantation she was admitted to the emergency due to sudden onset of confusion, disorientation, visual disturbances, and major headache. PRES was suspected and the diagnosis confirmed by brain MRI. Tacrolimus was withdrawn and rapid improvement of the neurological signs occurred leading to the conclusion that this drug triggered the syndrome. Conclusion: PRES is an unusual complication after organ transplantation and should be considered in the appropriate clinical setting. Physicians must be aware of this condition in order to provide early detection and appropriate treatment since delay in removing the cause may lead to permanent sequelae.
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Sociedade Brasileira de Nefrologia
2018
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oai:scielo:S0101-280020180001000912018-05-11Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case reportDavi,Carla BeatrizMoraes,Bruna Pinheiro deLichtenfels,Bruno FontesCastro Filho,João Batista Saldanha dePortal,Marcelle MariaMontenegro,Rosangela MunhozManfro,Roberto Ceratti Posterior Leukoencephalopathy Syndrome Kidney Transplantation Tacrolimus ABSTRACT Introduction: Posterior reversible leukoencephalopathy syndrome (PRES) was first described by Hinchey in 1996. The syndrome is characterized by altered level of consciousness, headache, visual changes, and seizures associated with a vasogenic edema of the white matter that occurs predominantly in the occipital and parietal lobes. Imaging tests such as computed tomography (CT) and especially magnetic resonance imaging (MRI) support the diagnosis. Case Report: We report a case of a 48-year-old female patient who underwent a deceased donor kidney transplant and received tacrolimus as a part of the immunosuppressive regimen. Five weeks after transplantation she was admitted to the emergency due to sudden onset of confusion, disorientation, visual disturbances, and major headache. PRES was suspected and the diagnosis confirmed by brain MRI. Tacrolimus was withdrawn and rapid improvement of the neurological signs occurred leading to the conclusion that this drug triggered the syndrome. Conclusion: PRES is an unusual complication after organ transplantation and should be considered in the appropriate clinical setting. Physicians must be aware of this condition in order to provide early detection and appropriate treatment since delay in removing the cause may lead to permanent sequelae.info:eu-repo/semantics/openAccessSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology v.40 n.1 20182018-03-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000100091en10.1590/1678-4685-jbn-3825 |
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Davi,Carla Beatriz Moraes,Bruna Pinheiro de Lichtenfels,Bruno Fontes Castro Filho,João Batista Saldanha de Portal,Marcelle Maria Montenegro,Rosangela Munhoz Manfro,Roberto Ceratti |
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Davi,Carla Beatriz Moraes,Bruna Pinheiro de Lichtenfels,Bruno Fontes Castro Filho,João Batista Saldanha de Portal,Marcelle Maria Montenegro,Rosangela Munhoz Manfro,Roberto Ceratti Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
author_facet |
Davi,Carla Beatriz Moraes,Bruna Pinheiro de Lichtenfels,Bruno Fontes Castro Filho,João Batista Saldanha de Portal,Marcelle Maria Montenegro,Rosangela Munhoz Manfro,Roberto Ceratti |
author_sort |
Davi,Carla Beatriz |
title |
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
title_short |
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
title_full |
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
title_fullStr |
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
title_full_unstemmed |
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report |
title_sort |
posterior reversible leukoencephalopathy syndrome (pres) after kidney transplantation: a case report |
description |
ABSTRACT Introduction: Posterior reversible leukoencephalopathy syndrome (PRES) was first described by Hinchey in 1996. The syndrome is characterized by altered level of consciousness, headache, visual changes, and seizures associated with a vasogenic edema of the white matter that occurs predominantly in the occipital and parietal lobes. Imaging tests such as computed tomography (CT) and especially magnetic resonance imaging (MRI) support the diagnosis. Case Report: We report a case of a 48-year-old female patient who underwent a deceased donor kidney transplant and received tacrolimus as a part of the immunosuppressive regimen. Five weeks after transplantation she was admitted to the emergency due to sudden onset of confusion, disorientation, visual disturbances, and major headache. PRES was suspected and the diagnosis confirmed by brain MRI. Tacrolimus was withdrawn and rapid improvement of the neurological signs occurred leading to the conclusion that this drug triggered the syndrome. Conclusion: PRES is an unusual complication after organ transplantation and should be considered in the appropriate clinical setting. Physicians must be aware of this condition in order to provide early detection and appropriate treatment since delay in removing the cause may lead to permanent sequelae. |
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Sociedade Brasileira de Nefrologia |
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2018 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000100091 |
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