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新型冠状病毒肺炎中的后部可逆性脑病综合征:一例报告

Posterior Reversible Encephalopathy Syndrome in COVID-19 Disease: a Case-Report.

作者信息

Llansó Laura, Urra Xabi

机构信息

Department of Neurology, Hospital Clínic, C/ Villarroel 170, 08036 Barcelona, Catalonia Spain.

Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Catalonia Spain.

出版信息

SN Compr Clin Med. 2020;2(10):1900-1902. doi: 10.1007/s42399-020-00470-2. Epub 2020 Aug 26.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome that can include headache, altered consciousness, visual disturbances, and seizures, usually related to autoregulatory cerebral failure and hypertension. The neuroimaging is essential to diagnosis, showing white matter vasogenic edema in posterior areas. We present a case of a 66-year-old woman with severe pneumonia by SARS-CoV-2 who developed a posterior reversible encephalopathy syndrome with a typical clinical and radiological presentation, after being treated with anti-interleukin treatment (anakinra and tocilizumab) following local guidelines. We report a case of posterior reversible encephalopathy syndrome in a patient with COVID-19 disease, possibly related to anti-IL-1 or anti-IL-6, suggesting that anti-interleukin treatments may cause this syndrome, at least in patients with predisposing conditions such as infections and hydroelectrolytic disorders.

摘要

后部可逆性脑病综合征(PRES)是一种临床综合征,可包括头痛、意识改变、视觉障碍和癫痫发作,通常与脑自动调节功能衰竭和高血压有关。神经影像学检查对诊断至关重要,显示后部区域存在白质血管源性水肿。我们报告一例66岁感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)肺炎的女性患者,在按照当地指南接受抗白细胞介素治疗(阿那白滞素和托珠单抗)后,出现了具有典型临床和影像学表现的后部可逆性脑病综合征。我们报告了一例新型冠状病毒肺炎(COVID-19)患者发生后部可逆性脑病综合征的病例,可能与抗白细胞介素-1(IL-1)或抗白细胞介素-6(IL-6)治疗有关,提示抗白细胞介素治疗可能会导致该综合征,至少在存在感染和水电解质紊乱等易感因素的患者中如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779b/7447596/fb7faa128b52/42399_2020_470_Fig1_HTML.jpg

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