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资源匮乏地区小儿后部可逆性脑病综合征的诊断挑战:一篇叙述性综述

Challenges of Diagnosing Pediatric Posterior Reversible Encephalopathy Syndrome in Resource Poor Settings: A Narrative Review.

作者信息

Ndu Ikenna Kingsley, Ayuk Adaeze Chikaodinaka, Onukwuli Vivian Ozoemena

机构信息

Enugu State University of Science and Technology, Enugu, Nigeria.

University of Nigeria, Enugu Campus, Nigeria.

出版信息

Glob Pediatr Health. 2020 Aug 12;7:2333794X20947924. doi: 10.1177/2333794X20947924. eCollection 2020.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare clinical syndrome that has been observed in different age groups, including pediatric patients. Identified triggers of PRES in both children and adults have included immunosuppressive and cytotoxic agents, organ transplantation, severe sepsis, blood transfusion, or evidence of human immunodeficiency virus-1 (HIV-1). Its clinical and radiological courses have been reported as mostly benign and reversible over days to weeks. Computed tomography (CT) scans are helpful in diagnosis, but magnetic resonance imaging (MRI) remains the gold standard. Unfortunately, because of the prohibitive costs of such medical equipment, diagnosis remains a challenge in developing countries. There is a dearth of information about pediatric PRES in resource-poor settings. This narrative aims to draw attention to the possible existence of PRES in children and to identify factors responsible for the difficulty in making the diagnosis. This review will hopefully increase awareness of PRES among pediatricians in order to make early diagnosis and institute appropriate management of this condition.

摘要

后部可逆性脑病综合征(PRES)是一种罕见的临床综合征,在包括儿科患者在内的不同年龄组中均有观察到。已确定的儿童和成人PRES触发因素包括免疫抑制和细胞毒性药物、器官移植、严重脓毒症、输血或人类免疫缺陷病毒1型(HIV-1)感染证据。据报道,其临床和影像学病程在数天至数周内大多为良性且可逆。计算机断层扫描(CT)有助于诊断,但磁共振成像(MRI)仍是金标准。不幸的是,由于此类医疗设备成本高昂,在发展中国家,诊断仍然是一项挑战。在资源匮乏地区,关于儿童PRES的信息匮乏。本叙述旨在提请注意儿童中可能存在的PRES,并确定导致诊断困难的因素。本综述有望提高儿科医生对PRES的认识,以便对该疾病进行早期诊断并采取适当的治疗措施。

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