Eroglu Nilgun, Bahadir Aysenur, Erduran Erol
Department of Pediatric Hematology and Oncology, Karadeniz Technical University, Trabzon, Turkey.
J Pediatr Hematol Oncol. 2017 Nov;39(8):e476-e478. doi: 10.1097/MPH.0000000000000827.
Posterior reversible encephalopathy syndrome (PRES), may be due to different causes. It may develop secondary to hypertension, renal decompensation, electrolyte imbalance, and chemotherapeutic drugs. We describe a case of acute lymphoblastic leukemia in which PRES developed secondary to hyponatremia despite being normotensive during receipt of chemotherapy. Magnetic resonance imaging findings were suggestive of PRES. Partial diffusion restriction was observed in lesions in the bilateral occipitoparietal regions and the cerebellum. The patient was treated with appropriate medications with the resolution of his stroke-like symptoms. No neurological deficit was observed and clinical condition improved. The patient continued with chemotherapy. Early diagnosis and treatment of this syndrome is important in terms of preventing neurological sequelae. Cases of secondary PRES developing for several etiological reasons have been reported in induction therapy, but no pediatric cases of PRES developing secondary to hyponatremia despite being normotensive while receiving chemotherapy in acute lymphoblastic leukemia have previously been reported.
后部可逆性脑病综合征（PRES）可能由不同原因引起。它可能继发于高血压、肾功能不全、电解质失衡和化疗药物。我们描述了一例急性淋巴细胞白血病患者，该患者在化疗期间血压正常，但因低钠血症继发了PRES。磁共振成像结果提示为PRES。在双侧枕顶叶区域和小脑的病变中观察到部分扩散受限。患者接受了适当的药物治疗，中风样症状得以缓解。未观察到神经功能缺损，临床状况有所改善。患者继续接受化疗。就预防神经后遗症而言，该综合征的早期诊断和治疗很重要。在诱导治疗中已报道了因多种病因继发PRES的病例，但此前尚未报道过急性淋巴细胞白血病患者在化疗期间血压正常但因低钠血症继发PRES的儿科病例。
