Saeed Bassam, Abou-Zor Najat, Amer Ziad, Kanani Issam, Hilal Mahmoud
Division of Pediatric Nephrology, Surgical Kidney Hospital, Ibn-Alnafis Medical Complex, Damascus, Syria.
Saudi J Kidney Dis Transpl. 2008 May;19(3):439-42.
Posterior reversible encephalopathy syndrome (PRES) is a recently proposed clinico-neuroradiological entity observed in a variety of clinical settings such as cyclosporin A (CsA) neurotoxicity. We report a 3.5-year-old Syrian boy in whom steroid-resistant focal segmental glomerulosclerosis (FSGS) was recently diagnosed. The patient remitted his nephrotic syndrome after 10 days of CsA administration. However, he shortly developed altered mental status, visual impairment, focal neurological deficits and seizures. We discontinued CsA that resulted in complete reversal of the patient's encephalopathical condition over a period of 4 months. We conclude that PRES should be suspected in immunosuppresed patients with kidney disease if they have a sudden episode of neurological symptoms.
后部可逆性脑病综合征（PRES）是一种最近提出的临床神经放射学实体，见于多种临床情况，如环孢素A（CsA）神经毒性。我们报告一名3.5岁的叙利亚男孩，他最近被诊断为类固醇抵抗性局灶节段性肾小球硬化（FSGS）。该患者在使用CsA 10天后肾病综合征缓解。然而，他很快出现了精神状态改变、视力损害、局灶性神经功能缺损和癫痫发作。我们停用了CsA，结果患者的脑病状况在4个月内完全逆转。我们得出结论，如果患有肾脏疾病的免疫抑制患者突然出现神经系统症状，应怀疑患有PRES。
