Koller Ana-Maria Roxana, Man Alexandra, Muntean Carmen
Department of Pediatrics, County Emergency Clinical Hospital Targu Mures, Romania.
George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
J Crit Care Med (Targu Mures). 2024 Jan 30;10(1):96-102. doi: 10.2478/jccm-2024-0004. eCollection 2024 Jan.
Posterior reversible encephalopathy syndrome (PRES) primarily shows neurological symptoms and is more frequent in males, often occurring in oncological patients. It can also be associated with renal conditions like post-streptococcal glomerulonephritis, a common cause of pediatric hypertension. Management involves blood pressure and seizure treatment. In some cases, it may lead to irreversible and severe complications. Early treatment is essential for prevention.
In the past six months, we have documented the cases of two patients, aged 15 and 10, both of whom presented with PRES and renal disease. These patients were admitted because of general malaise, headaches, nausea, vomiting, visual disturbances, and elevated blood pressure. Subsequently, both patients experienced epileptic episodes. Only the first patient required transfer to the Pediatric Intensive Care Unit (PICU). Cerebral magnetic resonance imaging (MRI) scans revealed distinct PRES lesions in both cases. Following comprehensive investigations, both cases were diagnosed with PRES in the context of acute post-streptococcal glomerulonephritis.
The patients showed improvement following the administration of antihypertensive and anticonvulsant medications, along with treatment for the underlying renal condition.
后部可逆性脑病综合征（PRES）主要表现为神经症状，在男性中更为常见，常发生于肿瘤患者。它也可能与肾脏疾病有关，如链球菌感染后肾小球肾炎，这是儿童高血压的常见原因。治疗包括控制血压和治疗癫痫发作。在某些情况下，它可能导致不可逆转的严重并发症。早期治疗对于预防至关重要。
在过去六个月里，我们记录了两名年龄分别为15岁和10岁的患者的病例，他们均患有PRES和肾脏疾病。这些患者因全身不适、头痛、恶心、呕吐、视觉障碍和血压升高而入院。随后，两名患者均出现癫痫发作。只有第一名患者需要转至儿科重症监护病房（PICU）。脑部磁共振成像（MRI）扫描显示两例均有明显的PRES病变。经过全面检查，两例均被诊断为急性链球菌感染后肾小球肾炎合并PRES。
患者在服用抗高血压和抗惊厥药物以及治疗潜在肾脏疾病后病情有所改善。
