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狼疮性肾病患者后可逆性脑病综合征(PRES)的致命结局:一例报告

Fatal outcome of posterior reversible encephalopathy syndrome (PRES) in a lupus nephropathy patient: A case report.

作者信息

Afilal Ihssane, Nasri Siham, Bendaoud Mustapha, Mahjouba Hajar, Guerrouj Imane, Aidid Fathia, Abbou Widad, Aichouni Narjisse, Kamaoui Imane, Skiker Imane

机构信息

Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda 60049, Morocco.

出版信息

Radiol Case Rep. 2022 Apr 19;17(6):2215-2219. doi: 10.1016/j.radcr.2022.03.084. eCollection 2022 Jun.

Abstract

Posterior reversible encephalopathy syndrome is a rare underestimated condition, that generally complicates a rise in blood pressure in an acute setting. This entity has been increasingly identified in patients with systemic lupus erythematosus disease. PRES is challenging to diagnose seeing as it presents with nonspecific neurological symptoms, such as head-aches, confusion, seizures, visual changes or a coma, and can mimic neuropsychiatric lupus. Imaging plays a necessary role in confirming this diagnosis, as it is characterized by vasogenic edema of the posterior white matter, in which the distribution is bilateral and symmetrical. Although this syndrome is rare, early diagnosis allows a prompt treatment and therefore a favorable outcome. We present a case report of PRES in a 14-year-old female previously diagnosed with lupus nephropathy, who presented to the emergency department with seizures and uncontrolled hypertension, that was unfortunately not reversible is this patient.

摘要

后部可逆性脑病综合征是一种罕见且易被低估的病症,通常在急性情况下因血压升高而并发。在系统性红斑狼疮患者中越来越多地发现了这种病症。由于后部可逆性脑病综合征表现为非特异性神经症状,如头痛、意识模糊、癫痫发作、视觉改变或昏迷,且可模仿神经精神性狼疮,因此诊断具有挑战性。影像学在确诊中起着必要作用,因为其特征是后部白质的血管源性水肿,分布为双侧对称。尽管这种综合征很罕见,但早期诊断可实现及时治疗,从而获得良好预后。我们报告一例14岁先前诊断为狼疮性肾炎的女性后部可逆性脑病综合征病例,该患者因癫痫发作和高血压控制不佳就诊于急诊科,遗憾的是该患者病情未能逆转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19bb/9048052/5fa19ce64462/gr1.jpg

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