Fukuyama Tetsuhiro, Tanaka Miyuki, Nakazawa Yozo, Motoki Noriko, Inaba Yuji, Higuchi Tsukasa, Koike Kenichi
Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
Pediatr Transplant. 2011 Dec;15(8):E169-73. doi: 10.1111/j.1399-3046.2010.01358.x. Epub 2010 Aug 24.
A six-yr-old boy developed PRES after induction chemotherapy for the relapse of acute lymphoblastic leukemia. Two months after PRES, he underwent BMT from an unrelated HLA-mismatched donor. There were many risk factors for PRES in the BMT including the long-term use of FK506 and methylprednisolone, grade III graft-versus-host disease, thrombotic microangiopathy, and sepsis. Prophylactic treatment for hypertension with nicardipine in conjunction with close monitoring of the magnesium level and the use of valproic acid might be an effective management approach to prevent post-transplant PRES.
一名6岁男孩在急性淋巴细胞白血病复发进行诱导化疗后发生了后部可逆性脑病综合征（PRES）。PRES发生两个月后，他接受了来自一名HLA不匹配的无关供者的骨髓移植（BMT）。BMT中有许多PRES的危险因素，包括长期使用他克莫司（FK506）和甲泼尼龙、Ⅲ级移植物抗宿主病、血栓性微血管病和败血症。使用尼卡地平进行高血压预防性治疗，同时密切监测镁水平并使用丙戊酸，可能是预防移植后PRES的有效管理方法。
