Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-29T16:59:49.534Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute Glomerulonephritis Presenting With PRES: A Report of 4 Cases

Published online by Cambridge University Press:  02 December 2014

E C Wirrell ,
L D Hamiwka ,
L A Hamiwka ,
S Grisaru  and
X Wei
E C Wirrell
Affiliation:
The Division of Pediatric Neurology, Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
L D Hamiwka
Affiliation:
The Division of Pediatric Neurology, Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
L A Hamiwka
Affiliation:
Division of Pediatric Nephrology, University of Calgary, Calgary, AB, Canada
S Grisaru
Affiliation:
Division of Pediatric Nephrology, University of Calgary, Calgary, AB, Canada
X Wei
Affiliation:
Department of Pediatrics, Radiology, University of Calgary, Calgary, AB, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Posterior reversible encephalopathy syndrome (PRES) occurs most commonly in the setting of known hypertension or use of immunosuppressive agents.

Design and Methods:

We report four previously-well children who presented acutely with altered mentation, seizures and visual disturbances and were diagnosed with PRES.

Results:

Only one child had a history of gross hematuria prior to the seizure. All four were discovered to be hypertensive only after onset of their neurological symptoms, and were subsequently diagnosed with glomerulonephritis. All four had rapid resolution of neurological symptoms with adequate treatment of hypertension.

Conclusions:

Blood pressure must be measured promptly in all children presenting with these symptoms. If elevated, the diagnosis of PRES should be strongly considered and a workup for renal disease pursued.

Résumé:

RÉSUMÉ:

Qustre observations cliniques de glomérulonéphrite aiguë avec tableau de SERP. Objectif : Le syndrome d'encéphalopathie réversible postérieure (SERP) se rencontre le plus souvent dans le cadre d'une hypertension connue ou de la prise d'immunosuppresseurs. Plan d'étude et méthodes : Nous décrivons quatre enfants en bonne santé qui ont présenté de façon aiguë une détérioration de l'état mental, des convulsions et des troubles visuels, chez qui on a posé un diagnostic de SERP. Résultats : Un seul enfant avait une histoire d'hématurie macroscopique avant les convulsions. On a posé un diagnostic d'hypertension chez tous seulement après le début des symptômes neurologiques et un diagnostic de glomérulonéphrite a été posé par la suite. Les symptômes neurologiques ont disparu rapidement après traitement adéquat de l'hypertension. Conclusions : La pression artérielle doit être mesurée rapidement chez tous les enfants qui présentent ce tableau clinique. Si elle est élevée, il est important de considérer qu'il pourrait s'agir d'un SERP et de procéder à un bilan rénal.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 3 , August 2007 , pp. 316 - 321
Copyright
Copyright © The Canadian Journal of Neurological 2007

References

1. Hinchey, J, Chaves, C, Appignani, B, Breen, J, Pao, L, Wang, A, et al. A reversible posterior leukoencephalopathy syndrome. New Engl J Med. 1996;334:494–500.Google Scholar
2. Ohta, T, Sakano, T, Shiotsu, M, Furue, T, Ohtani, H, Kinoshita, Y, et al. Reversible posterior leukoencephalopathy in a patient with Wegener granulomatosis. Pediatr Nephr. 2004;19:442–4.CrossRefGoogle Scholar
3. Soylu, A, Kavukcu, S, Turkmen, M, Akbas, Y. Posterior leukoencephalopathy syndrome in poststreptococcal acute glomerulonephritis. Pediatr Nephr. 2001;16:601–3.CrossRefGoogle ScholarPubMed
4. Ozcakar, ZB, Ekim, M, Fitoz, S, Teber, S, Hizel, S, Acar, B, et al. Hypertension induced reversible posterior leukoencephalopathy syndrome: a report of two cases. Eur J Pediatr. 2004;163:728–30.Google Scholar
5. Ohtomo, Y, Takada, M, Fujinaga, S, Murakami, H, Yamashiro, Y. Hypertensive encephalopathy in a boy with biopsy-proven acute post-streptococcal glomerulonephritis. Pediatr Int. 2005;47:323–5.Google Scholar
6. Yang, MH, Sheu, JN, Wang, SJ. Cortical blindness in a boy with acute glomerulonephritis. J Formos Med Assoc. 2003;102:52–4.Google Scholar
7. Froehlich, T, Sandifer, S, Varma, P, Testa, F. Case report: two cases of hypertension-induced reversible posterior leukoencephalopathy syndrome secondary to glomerulonephritis. Curr Opin Pediatr. 1999;11: 12–18.CrossRefGoogle ScholarPubMed
8. Fux, CA, Bianchetti, MG, Jakob, SM, Remonda, L. Reversible encephalopathy complicating post-streptococcal glomerulonephritis. Ped Infect Dis J. 2006;25:85–7.Google Scholar
9. Aeby, A, David, P, Fricx, C, Jissendi, P, Blecic, S, Van Bogaert, P. Posterior reversible encephalopathy syndrome revealing acute post-streptococcal glomerulonephritis. J Child Neurol. 2006;21:250–1.Google Scholar
10. Pan, CG. Glomerulonephritis in childhood. Curr Opin Pediatr. 1997;9:154–9.Google Scholar
11. Brubaker, LM, Smith, JK, Lee, YZ, Lin, W, Castillo, M. Hemodynamic and permeability changes in posterior reversible encephalopathy syndrome measured by dynamic susceptibility perfusionweighted MR imaging. AJNR Am J Neuroradiol. 2005;26:825–30.Google Scholar
12. Owman, C, Edvinsson, L, Nielson, KC. Autonomic neuroreceptor mechanisms in brain vessels. In: Fuxe, K, Olson, L, Zotterman, Y, editors. Dynamics of degeneration ad growth in neurons. New York: Pergamon; 1974. p. 535–60.Google Scholar
13. Ito, S, Nezu, A, Matsumoto, C, Aihara, Y, Yokota, S. Acute disseminated encephalomyelitis and poststreptococcal acute glomerulonephritis. Brain Dev. 2002;24:88–90.Google Scholar
14. Casey, SO, Sampaio, RC, Michel, E, Truwit, CL. Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. Am J Neuroradiol. 2000;21:1199–206.Google Scholar
15. Covarrubias, DJ, Luetmer, PH, Campeau, NG. Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images. Am J Neuroradiol. 2002;23:1038–48.Google Scholar
16. Kwon, S, Koo, J, Lee, S. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Pediatr Neurol. 2001;24:361–4.Google Scholar
17. Eichler, FS, Wang, P, Wityk, RJ, Beauchamp, NJ, Barker, PB. Dynamic metabolic abnormalities in reversible posterior leukoencephalopathy syndrome. Am J Neuroradiol. 2002;23:833–7.Google Scholar