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急性感染后肾小球肾炎诱发的后部可逆性脑病综合征

Posterior Reversible Encephalopathy Syndrome Induced by an Acute Postinfectious Glomerulonephritis.

作者信息

Ouachaou Jamal, Laaribi Ilyass, Maarad Mohammed, Zaid Ikram, Alkouh Rajae, Bkiyar Houssam, Housni Brahim

机构信息

Intensive Care Unit, Mohammed VI University Hospital Center, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, Morocco.

出版信息

Int J Pediatr. 2021 Mar 3;2021:8850092. doi: 10.1155/2021/8850092. eCollection 2021.

Abstract

Posterior reversible encephalopathy (PRES) is a rare but a serious disease that affects the central nervous system. PRES is responsible for various but nonspecific neurological symptoms, including confusion, coma, and seizures as well as visual disturbances. Diagnosis is made using cerebral MRI which typically shows at the early stage, bilateral symmetrical parietooccipital hyperintensities on T2 and fluid-attenuated inversion recovery (FLAIR) sequences. . In this article, we base our research on a case study that includes, as a population sample, a 9-year-old boy who suffers from an acute postinfectious glomerulonephritis and arterial hypertension. Two days before diagnosis, he developed confusion with generalized tonic-clonic attacks. His blood pressure was 180/80 mmHg. A cerebral computed tomography made in emergency showed cerebral edema. It was supplemented by magnetic resonance imaging which revealed cortical and posterior cortical lesions which appear as hypointense on T1 and hyperintense on T2 and Flair. An MRI control was performed 40 days later which shows a clear improvement of the occipital lesions. PRES is a radioclinical syndrome characterized by the association of variable neurological signs which reversibility is conditioned by the early diagnosis and the correction of the contributing factors.

摘要

后部可逆性脑病(PRES)是一种罕见但严重的影响中枢神经系统的疾病。PRES可导致各种非特异性神经症状,包括意识模糊、昏迷、癫痫发作以及视觉障碍。诊断通过脑部MRI进行,在疾病早期,T2加权像和液体衰减反转恢复序列(FLAIR)上通常显示双侧对称的顶枕叶高信号。在本文中,我们基于一个病例研究展开,该病例作为人群样本,是一名9岁男孩,患有急性感染后肾小球肾炎和动脉高血压。在诊断前两天,他出现意识模糊并伴有全身性强直阵挛发作。他的血压为180/80 mmHg。急诊脑部计算机断层扫描显示脑水肿。随后进行的磁共振成像显示皮质和皮质后部病变,在T1加权像上呈低信号,在T2加权像和FLAIR序列上呈高信号。40天后进行的MRI复查显示枕叶病变明显改善。PRES是一种放射临床综合征,其特征是多种神经体征同时出现,其可逆性取决于早期诊断和相关因素的纠正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0587/7952175/25988a26d775/IJPEDI2021-8850092.001.jpg

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