Falsetti Paolo, Acciai Caterina, Conticini Edoardo, Cantarini Luca, Frediani Bruno
Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
Neurorehabilitation Unit, S. Donato Hospital, Arezzo, Italy.
Curr Health Sci J. 2021 Apr-Jun;47(2):306-309. doi: 10.12865/CHSJ.47.02.23. Epub 2021 Jun 30.
Posterior reversible encephalopathy syndrome (PRES) is a potentially life-threatening condition, composed of focal neurologic symptoms and peculiar magnetic resonance imaging (MRI) findings suggestive for cerebral vasogenic edema. PRES has been predominantly associated with severe hypertension, but a concomitant inflammatory state, common in vasculitis, can contribute to worsening cerebral vasogenic edema towards cytotoxic edema, and it should be promptly treated with glucocorticoids (GC). Atypical cases of PRES should be suspected in cases of focal neurologic symptoms, associated with severe hypertension, and systemic inflammation. We report the first description of a patient with polymyalgia rheumatica and giant cell arteritis who developed PRES after GC discontinuation for arthroscopic surgery.
后部可逆性脑病综合征（PRES）是一种潜在的危及生命的疾病，由局灶性神经症状和提示脑源性血管性水肿的特殊磁共振成像（MRI）表现组成。PRES主要与严重高血压相关，但血管炎中常见的伴随炎症状态可导致脑源性血管性水肿恶化为细胞毒性水肿，应立即用糖皮质激素（GC）治疗。对于伴有严重高血压和全身炎症的局灶性神经症状患者，应怀疑为非典型PRES病例。我们报告了首例患有风湿性多肌痛和巨细胞动脉炎的患者，在因关节镜手术停用GC后发生了PRES。
