Zhongguo linchuang yanjiu (Jun 2023)
Reversible posterior encephalopathy syndrome in children with renal disease
Abstract
Objective To summarize the clinical characteristics of posterior reversible encephalopathy syndrome (PRES) in children with renal disease in order to provide reference for early prevention, diagnosis and treatment and improving prognosis. Methods A retrospective analysis was conducted on the clinical characteristics, auxiliary examinations, medication use and prognosis of children with renal disease complicated with PRES confirmed in the First Affiliated Hospital of Henan University of Chinese Medicine from 2015 to 2022, and the relevant literatures were reviewed. Results Thirteen children aged 3 to 14 (8.38±3.36) years old were enrolled, including 9 males and 4 females. There were 10 cases (76.92%) of infection before the onset of the disease, 10 cases (76.92%) of lower serum albumin levels than normal, 4 cases (30.77%) accompanied by varying degrees of hypertension, 10 cases (76.92%) treated with glucocorticoids (GC) combined with immunosuppressive agents, 2 cases (15.38%) treated with GC and 1 case (7.69%) treated with immunosuppressive agents. The main clinical manifestations were seizures, disturbance of consciousness, nausea and vomiting, dizziness, headache and ocular discomfort. The lesions were mostly distributed in bilateral frontal lobe, parietal lobe, temporal lobe, occipital cortex and subcortex. After treatment, the clinical manifestations and imaging findings returned to normal in a short period of time. Conclusion The incidence of PRES in children with renal disease is related to GC and immunosuppressive therapy, and cyclic lipopeptide antibiotics, hypoproteinemia and hypertension may increase the risk of disease. PRES usually is reversible and has a good prognosis, but delayed treatment can worsen progressively and even cause irreversible craniocerebral nerve damage.
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