Nisar Taha, Alchaki Abdul R, Feinstein Erin
Rutgers New Jersey Medical School, Newark, USA.
Case Rep Neurol Med. 2019 Sep 29;2019:2418597. doi: 10.1155/2019/2418597. eCollection 2019.
Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of headache, altered mental status, and seizures with reversible mainly posterior leukoencephalopathy on neuroimaging. Precipitating factors for PRES are multifactorial and include autoregulatory failure due to changes in blood pressure, metabolic derangements, and cytotoxic medications. We report the second case of cyclophosphamide-induced PRES in a patient with anti-glomerular basement membrane (Anti-GBM) positive vasculitis. In the acute setting, PRES can be challenging to distinguish from cerebral venous sinus thrombosis or cerebral vasculitis based on clinical presentation. Neuroimaging with magnetic resonance imaging (MRI) of the brain along with a vessel imaging, can help reach the diagnosis.
后部可逆性脑病综合征(PRES)是一种临床综合征,表现为头痛、精神状态改变和癫痫发作,神经影像学检查主要显示后部白质脑病具有可逆性。PRES的诱发因素是多方面的,包括血压变化导致的自动调节功能衰竭、代谢紊乱和细胞毒性药物。我们报告了第二例环磷酰胺诱发的PRES病例,该患者为抗肾小球基底膜(Anti-GBM)阳性血管炎。在急性期,基于临床表现,PRES可能难以与脑静脉窦血栓形成或脑血管炎相鉴别。脑部磁共振成像(MRI)以及血管成像有助于做出诊断。