Gurumurthy Vaishnavi, Jain Gauri
Department of PID, Indian Council of Medical Research-NIIH, Mumbai.
Emergency Department, Ashoka Medicover Hospital, Nashik, India.
Ann Med Surg (Lond). 2023 Apr 10;85(5):1975-1977. doi: 10.1097/MS9.0000000000000523. eCollection 2023 May.
Sickle cell disease has many clinical impacts, one such rare finding is systemic hypertension although the literature to support it is debatable. Hypertension along with other key components of sickle cell pathology is one of the reversible causes of posterior reversible encephalopathy syndrome (PRES). Although its triggering factors and pathophysiology is not well documented, hypertension is one of the easily reversible causes of PRES. A well-controlled blood pressure is an aim for reversibility and future recurrence of PRES. However, the addition of other medications like anticonvulsants (levetiracetam and lacosamide) to prevent seizures as a consequence of PRES still remains debatable. Considering the case reported below, the addition of Hydroxyurea to the treatment can be another cause of the recurrence of PRES and needs to be weighed for its risks and benefits.
镰状细胞病有许多临床影响，其中一个罕见的表现是系统性高血压，尽管支持这一观点的文献存在争议。高血压与镰状细胞病理的其他关键因素一起，是后部可逆性脑病综合征（PRES）的可逆性病因之一。尽管其触发因素和病理生理学尚未得到充分记录，但高血压是PRES的易逆转病因之一。良好控制血压是PRES可逆性及未来复发预防的目标。然而，添加其他药物如抗惊厥药（左乙拉西坦和拉科酰胺）以预防PRES导致的癫痫发作仍存在争议。考虑到下面报道的病例，添加羟基脲进行治疗可能是PRES复发的另一个原因，需要权衡其风险和益处。
