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[PMID]:29269696
[Au] Autor:Yokoi K; Ando T; Kawakami O
[Ad] Endereço:Department of Neurology, Anjo Kosei Hospital.
[Ti] Título:[Case of posterior reversible encephalopathy syndrome caused by Fisher syndrome].
[So] Source:Rinsho Shinkeigaku;58(1):45-48, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:This report presents a case of a 71-year-old woman with Fisher syndrome who had posterior reversible encephalopathy syndrome (PRES) before the initiation of intravenous immunoglobulin (IVIg) treatment. She had symptoms of common cold 2 weeks before the onset of PRES. On the day of the onset, she began to stagger while walking. On day 2, she developed hypertension, vision impairment, and limb weakness and was admitted to the hospital. On day 3, she was provided steroid pulse therapy. On day 4, she developed convulsions and right imperfection single paralysis and was transferred to the our hospital. During the transfer, the patient was conscious. Her blood pressure was high at 198/107 mmHg. She had mild weakness in her limbs and face, light perception in both eyes, dilation of both pupils, total external ophthalmoplegia, no tendon reflexes, and limb and trunk ataxia. We diagnosed PRES because of the high signal intensities observed on T -weighted MRI on both sides of the parietal and occipital lobes. We also diagnosed Fisher syndrome because of a positive anti-GQ1b immunoglobulin G antibody test and albuminocytologic dissociation in the cerebrospinal fluid. PRES showed prompt improvement with antihypertensive therapy, whereas Fisher syndrome slowly improved over a course of 2 months. This case is the first report of PRES without IVIg suggesting that Fisher syndrome induces hypertension and causes PRES.
[Mh] Termos MeSH primário: Síndrome de Miller Fisher/complicações
Síndrome da Leucoencefalopatia Posterior/etiologia
[Mh] Termos MeSH secundário: Idoso
Anti-Hipertensivos/administração & dosagem
Biomarcadores/sangue
Biomarcadores/líquido cefalorraquidiano
Proteínas do Líquido Cefalorraquidiano/líquido cefalorraquidiano
Diltiazem/administração & dosagem
Feminino
Gangliosídeos/imunologia
Seres Humanos
Imunoglobulina G/sangue
Imunoglobulinas Intravenosas
Imagem por Ressonância Magnética
Síndrome de Miller Fisher/diagnóstico
Neuroimagem
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico
Resultado do Tratamento
Valsartana/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Biomarkers); 0 (Cerebrospinal Fluid Proteins); 0 (Gangliosides); 0 (Immunoglobulin G); 0 (Immunoglobulins, Intravenous); 68652-37-9 (GQ1b ganglioside); 80M03YXJ7I (Valsartan); EE92BBP03H (Diltiazem)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001089


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[PMID]:29200159
[Au] Autor:Banerjee JS; Heyman M; Palomäki M; Lähteenmäki P; Arola M; Riikonen PV; Möttönen MI; Lönnqvist T; Taskinen MH; Harila-Saari AH
[Ad] Endereço:Children's Hospital, University of Helsinki and Helsinki University Hospital, Division of Pediatric Hematology-Oncology and Stem Cell Transplantation.
[Ti] Título:Posterior Reversible Encephalopathy Syndrome: Risk Factors and Impact on the Outcome in Children With Acute Lymphoblastic Leukemia Treated With Nordic Protocols.
[So] Source:J Pediatr Hematol Oncol;40(1):e13-e18, 2018 Jan.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Posterior reversible encephalopathy syndrome (PRES) in children with acute lymphoblastic leukemia has been increasingly recognized as a clinicoradiological entity. Our aim was to describe the incidence of PRES in pediatric patients with ALL, identify its risk factors, and examine its prognostic importance. For this research, we conducted a systematic, retrospective review of the patient records in a population-based series of children with acute lymphoblastic leukemia (n=643) treated in Finland from 1992 to 2008. Of the patients with ALL, 4.5% (n=29) developed radiologically confirmed PRES, of which 28 cases occurred during induction. Hypertension (P=0.006; odds ratio [OR], 4.10, confidence interval [CI], 1.50-11.25), constipation (P=0.001; OR, 5.60; CI, 2.02-15.52), and >14 days of alkalinization (P=0.017; OR, 3.27; CI, 1.23-8.68) were significant independent risk factors for PRES. One-third of the patients developed epilepsy. Relapses occurred significantly more often in those patients with PRES (P=0.001), which was associated with worse overall survival (P=0.040; 5-year survival=75.9% [60.3%-91.4%] vs. 88.4% [85.8%-90.9%]). Using NOPHO-ALL 92/2000 protocols, PRES is a significant early complication of therapy in ALL, and was associated with a poorer prognosis and significant neurological morbidity.
[Mh] Termos MeSH primário: Síndrome da Leucoencefalopatia Posterior/induzido quimicamente
Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Epilepsia/etiologia
Feminino
Finlândia/epidemiologia
Seres Humanos
Hipertensão/etiologia
Incidência
Quimioterapia de Indução/efeitos adversos
Lactente
Masculino
Síndrome da Leucoencefalopatia Posterior/epidemiologia
Síndrome da Leucoencefalopatia Posterior/etiologia
Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico
Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Convulsões/etiologia
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000001009


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[PMID]:29245268
[Au] Autor:Shi F; Shen L; Shi Y; Shi L; Yang X; Jin Z; Liu W; Wu D
[Ad] Endereço:Department of Neurology, Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai, China.
[Ti] Título:Posterior reversible encephalopathy syndrome after postpartum hemorrhage and uterine artery embolization: A case report.
[So] Source:Medicine (Baltimore);96(49):e8973, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is characterized by clinical and radiological features, including headache, disturbed consciousness, seizures, and cortical blindness associated with findings indicating posterior leukoencephalopathy on imaging studies. Ours is the first case of PRES developing after postpartum hemorrhage and uterine artery embolization. PATIENT CONCERNS: An 18-year-old patient had postpartum hemorrhage after a normal delivery. She required uterine artery embolization to stop the bleeding; however, she developed PRES 2 hours after the surgery. DIAGNOSES: Brain computed tomography suggested subarachnoid hemorrhage or cerebral venous sinus thrombosis. However, findings on magnetic resonance imaging were highly indicative of PRES. INTERVENTIONS: The patient received diazepam and midazolam to prevent seizures. OUTCOMES: Seizures were controlled on the first day. The patient's visual acuity returned to normal on the fourth day of admission. Thirteen days after admission, her neurological signs and symptoms were completely managed. LESSONS: PRES may be related to postpartum hemorrhage, blood pressure fluctuation, inflammation, and contrast agents. Collectively, they cause a breakage in the blood-brain barrier and endothelial cell damage, eventually leading to PRES. We also found PRES had many features similar with contrast-induced encephalopathy.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Diazepam/uso terapêutico
Hipnóticos e Sedativos/uso terapêutico
Midazolam/uso terapêutico
Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico
Síndrome da Leucoencefalopatia Posterior/etiologia
Hemorragia Pós-Parto/terapia
Embolização da Artéria Uterina
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Imagem por Ressonância Magnética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Hypnotics and Sedatives); Q3JTX2Q7TU (Diazepam); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008973


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[PMID]:28465499
[Au] Autor:Ramirez R; Muskula PR; Everley MP
[Ad] Endereço:Department of Cardiology, Saint Luke's Mid-America Heart Institute, Kansas City, MO, USA.
[Ti] Título:Posterior Reversible Encephalopathy Syndrome After Orthotopic Heart Transplantation: A Case Report.
[So] Source:Am J Case Rep;18:487-490, 2017 May 03.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Calcineurin inhibitor-induced posterior reversible encephalopathy syndrome (PRES) is well described in liver and kidney transplant patients, but there is a paucity of data in heart transplant patients. PRES syndrome in the setting of heart transplantation can occur as early as 5 days following transplantation. CASE REPORT A 32-year-old woman who had recently undergone orthotopic heart transplantation developed headaches, visual disturbances, and generalized tonic clonic seizures 5 days after initiating anti-rejection therapy (tacrolimus, mycophenolate, and prednisone). No focal neurological deficits were noted on physical exam. Multifocal subcortical fluid attenuation inversion recovery (FLAIR) hyperintensity signals and areas of diffusion restriction with postcontrast enhancement, diagnostic of PRES, were found on MRI brain. Her symptoms resolved 2 days after tacrolimus was switched to cyclosporine. A follow-up MRI after 6 weeks demonstrated complete resolution of areas of flair hyperintensity signal. She was sent home on a short course of seizure prophylaxis, which was discontinued after the resolution of radiological findings. She had no further episodes of seizures for 6 months following discontinuation of her anti-epileptic regimen. CONCLUSIONS Tacrolimus-induced PRES can occur as early as 5 days after orthotopic heart transplantation. Early recognition of symptoms and management can prevent permanent neurological sequelae.
[Mh] Termos MeSH primário: Transplante de Coração
Imunossupressores/efeitos adversos
Síndrome da Leucoencefalopatia Posterior/induzido quimicamente
Tacrolimo/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunosuppressive Agents); WM0HAQ4WNM (Tacrolimus)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28797767
[Au] Autor:Dong XY; Bai CB; Nao JF
[Ad] Endereço:Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, China.
[Ti] Título:Clinical and radiological features of posterior reversible encephalopathy syndrome in patients with pre-eclampsia and eclampsia.
[So] Source:Clin Radiol;72(10):887-895, 2017 Oct.
[Is] ISSN:1365-229X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To analyse and summarise clinical and radiological features among patients with posterior reversible encephalopathy syndrome (PRES), to assess related factors with eclampsia and pre-eclampsia, and to compare the different factors between cytotoxic and vasogenic oedema among PRES patients. MATERIALS AND METHODS: The clinical and radiological findings of 237 pre-eclamptic or eclamptic patients with neurological symptoms were evaluated retrospectively. Multiple logistic regression analyses were performed to compare the differences among these parameters. RESULTS: Seventy-six patients (32.07%) were diagnosed with PRES. Multiple logistic regression indicated that seizure (odds ratio [OR], 2.760; 95% confidence interval [CI]: 1.087-7.011; p=0.033), visual disturbances (OR=2.062 95%CI, 1.033-4.115; p=0.004), multiple production history (OR=3.637; 95% CI: 1.068-8.228; p=0.002) were independent risk factors for PRES. PRES+ (OR=3.217; 95%CI, 1.346-7.686; p=0.009), Visual disturbances (OR=4.283; 95% CI: 1.843-9.953; p=0.001) had strong association with eclampsia. Visual disturbances (OR=7.200; 95% CI: 2.116-24.496; p=0.002) had strong correlation with eclampsia among PRES+ patients. Visual disturbances (OR=2.947; 95% CI: 1.135-7.648; p=0.026) were independently related to cytotoxic oedema. CONCLUSIONS: Nearly one-third of pre-eclampsia or eclampsia patients with neurological symptoms have PRES. Visual disturbances, seizure, multiple production history are independent risk factors for PRES. Visual disturbances have a strong association with eclampsia whether patients have PRES or not. Visual disturbances are independently related to cytotoxic oedema among PRES+ patients.
[Mh] Termos MeSH primário: Eclampsia/diagnóstico
Imagem por Ressonância Magnética
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Pré-Eclâmpsia/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Anticonvulsivantes/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Encéfalo/diagnóstico por imagem
Diazepam/uso terapêutico
Eclampsia/terapia
Feminino
Seres Humanos
Labetalol/uso terapêutico
Sulfato de Magnésio/uso terapêutico
Neuroimagem/métodos
Fenitoína/uso terapêutico
Síndrome da Leucoencefalopatia Posterior/diagnóstico
Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico
Pré-Eclâmpsia/terapia
Gravidez
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Antihypertensive Agents); 6158TKW0C5 (Phenytoin); 7487-88-9 (Magnesium Sulfate); Q3JTX2Q7TU (Diazepam); R5H8897N95 (Labetalol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE


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[PMID]:28682904
[Au] Autor:Shin HY; Kim SH; Lee MY; Yoon SA; Kim SY; Lee YC
[Ad] Endereço:aDepartment of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University of Korea bDivision of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
[Ti] Título:Sudden bilateral vision loss as the sole manifestation of posterior reversible encephalopathy syndrome from acute uremia: Clinical case report.
[So] Source:Medicine (Baltimore);96(27):e7424, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity associated with vasogenic edema. Symptoms may include headache, seizures, altered mental status, and visual impairment. Patients with PRES generally present with neurological deficits. PATIENT CONCERNS: Here, we report an unusual case of a 42-year-old man who presented with sudden bilateral vision loss without any other neurologic symptoms. DIAGNOSES: He was diagnosed with PRES secondary to acute uremia. INTERVENTIONS AND OUTCOMES: Our patient experienced a dramatic improvement in visual acuity, blood chemistry values, and magnetic resonance imaging findings following repeated hemodialysis. LESSONS: Sudden bilateral vision loss may be the sole manifestation of PRES, particularly in patient with risk factors for PRES. Awareness of this variation of the clinical symptoms of PRES is important to facilitate its recognition.
[Mh] Termos MeSH primário: Síndrome da Leucoencefalopatia Posterior/diagnóstico
Síndrome da Leucoencefalopatia Posterior/etiologia
Uremia/complicações
Transtornos da Visão/diagnóstico
Transtornos da Visão/etiologia
[Mh] Termos MeSH secundário: Adulto
Encéfalo/diagnóstico por imagem
Diagnóstico Diferencial
Seres Humanos
Masculino
Síndrome da Leucoencefalopatia Posterior/terapia
Diálise Renal
Uremia/diagnóstico
Uremia/terapia
Transtornos da Visão/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007424


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[PMID]:28682567
[Au] Autor:Vergura M; Prencipe M; Del Giudice AM; Grifa R; Miscio F; Pennelli AM; Popolizio T; Simeone A; Ferrara M; Leone M; Aucella F
[Ad] Endereço:Struttura Complessa di Nefrologia e Dialisi IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italia.
[Ti] Título:[PRES (Posterior Reversible Encephalopathy Syndrome): potential complication of hypertensive crisis. Case report and literature review].
[So] Source:G Ital Nefrol;34(2):100-109, 2017 Apr.
[Is] ISSN:1724-5990
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, usually reversible, characterized by vasogenic oedema in cerebral posterior regions in patients with autoimmune diseases, nephropathies, hypertensive crisis, eclampsia and exposure to cytotoxic drugs. The main symptoms are: headache, nausea, vomiting, seizures, visual disturbance and altered consciousness. Complications as cerebral hemorrhage and recurrences are rare. We describe a case of a 65 years old woman, affected by chronic kidney disease, recently exacerbated, diabetes and hypertension in treatment, who showed an heterogeneous clinical presentation with vomiting, headache, blurred vision and impaired consciousness during an episode of acute hypertension. After an adjustement of the antihypertensive treatment we observed a regression of symptoms in one week. FLAIR sequences on MRI showed cerebral bilateral vasogenic oedema in posterior regions, typical for PRES. This case was suggestive for PRES and a prompt adjustement of the antihypertensive treatment was critical for clinical recovery. Brain MRI was crucial for diagnosis. It is important for clinicians to recognize PRES as a possible complication of renal disease and hypertensive crisis.
[Mh] Termos MeSH primário: Hipertensão/complicações
Síndrome da Leucoencefalopatia Posterior/etiologia
Insuficiência Renal Crônica/complicações
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Imagem por Ressonância Magnética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE


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[PMID]:28422884
[Au] Autor:Lio CF; Lee YH; Chan HY; Yu CC; Peng NJ; Chan HP
[Ad] Endereço:aDepartment of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan bCentro Hospitalar Conde de São Januário, Macao, China cDepartment of Medicine, National Defense Medical Center, Taipei City dDepartment of Emergency, E-Da Hospital, Kaohsiung City eSchool of Medicine, National Yang-Ming University, Taipei City, Taiwan.
[Ti] Título:Posterior reversible encephalopathy syndrome in a postpartum hemorrhagic woman without hypertension: A case report.
[So] Source:Medicine (Baltimore);96(16):e6690, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Posterior reversible encephalopathy syndrome (PRES), which diagnosis is based on clinical symptoms and radiological features, is a neurotoxic disease characterized by a set of clinical manifestations, such as seizure, headache, visual, and/or consciousness disturbance. It is the first case of PRES followed by postpartum hemorrhage (PPH) without underlying disease. PATIENT CONCERNS: A 37-year-old healthy woman had PPH after caesarean section. Six days after delivery, headache occurred suddenly, followed by episodes of clonus seizure. DIAGNOSES: Brain computed tomography showed ischemic stroke. However, magnetic resonance imaging revealed characteristics consistent with PRES. INTERVENTIONS: The patient received phenytoin for seizure control. OUTCOMES: Seizure was under good control over the following days. Three months later, repeated magnetic resonance imaging showed complete remission. LESSONS: PRES may be triggered by PPH and is not necessarily secondary to typical predisposing factors such as hypertension or pre/eclampsia. Hormone fluctuation, increased blood pressure variation, and massive blood transfusion may be contributed to the development of PRES in our case. Also, it is necessary to rule out those life-threatening diseases, such as cavernoma hemorrhage, cerebral venous thrombosis, and ischemic stroke before the diagnosis of PRES.
[Mh] Termos MeSH primário: Síndrome da Leucoencefalopatia Posterior/etiologia
Hemorragia Pós-Parto
[Mh] Termos MeSH secundário: Adulto
Cesárea
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Convulsões/etiologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006690


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[PMID]:28417553
[Au] Autor:Shkalim-Zemer V; Konen O; Levinsky Y; Michaeli O; Yahel A; Krauss A; Yaniv I; Stein J
[Ad] Endereço:Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
[Ti] Título:Calcineurin inhibitor-free strategies for prophylaxis and treatment of GVHD in children with posterior reversible encephalopathy syndrome after stem cell transplantation.
[So] Source:Pediatr Blood Cancer;64(11), 2017 Nov.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a distinct clinico-radiologic entity that can occur following allogeneic hematopoietic stem cell transplantation, often in the context of treatment with calcineurin inhibitors (CNIs). PROCEDURE: We describe the results of CNI-free management of 14 children with PRES and review the clinical and radiologic manifestations of their presentation. RESULTS: Discontinuation of CNIs usually resulted in remission of PRES, but patients with established graft versus host disease (GVHD) at the time when treatment was changed often experienced progressive GVHD despite administration of immune suppressive and modulating treatments. All but three patients experienced full neurologic recovery. Nine children died as a result of either GVHD, disease relapse, or severe infection. CONCLUSIONS: Discontinuation of CNIs results in neurologic improvement in most cases, but superior alternative immune modulatory treatment is needed to prevent progression of established GVHD.
[Mh] Termos MeSH primário: Inibidores de Calcineurina/efeitos adversos
Doença Enxerto-Hospedeiro/terapia
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Síndrome da Leucoencefalopatia Posterior/etiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seguimentos
Doença Enxerto-Hospedeiro/etiologia
Neoplasias Hematológicas/terapia
Seres Humanos
Masculino
Prognóstico
Transplante Homólogo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcineurin Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26531


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[PMID]:28416534
[Au] Autor:Miller-Patterson C; Fehnel CR
[Ad] Endereço:Department of Neurology, Rhode Island Hospital, Brown University Alpert Medical School, Providence, Rhode Island, USA.
[Ti] Título:Pazopanib-associated posterior reversible encephalopathy syndrome with intracerebral haemorrhage.
[So] Source:BMJ Case Rep;2017, 2017 Apr 17.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Pazopanib is a tyrosine kinase receptor antagonist used for renal cell carcinoma and soft tissue sarcoma that inhibits tumour growth and angiogenesis. A common side effect of pazopanib is hypertension. We report a case of a 69-year-old woman with clear cell renal cell carcinoma who developed a large right occipital intracerebral haemorrhage 3 weeks after initiating pazopanib. Although this was initially suspected to be a haemorrhagic metastasis, MRI revealed bi-occipital oedema, supporting a diagnosis of posterior reversible encephalopathy syndrome (PRES). A craniectomy was required. Immunohistochemical stains for renal cell carcinoma antigen, CA IX and PAX8 were negative. This case suggests that PRES and intracerebral haemorrhage may result from pazopanib use and are important complications to consider prior to initiating this agent.
[Mh] Termos MeSH primário: Hemorragia Cerebral/etiologia
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Pirimidinas/administração & dosagem
Sulfonamidas/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Renais/tratamento farmacológico
Craniectomia Descompressiva
Feminino
Seres Humanos
Neoplasias Renais/tratamento farmacológico
Imagem por Ressonância Magnética
Síndrome da Leucoencefalopatia Posterior/induzido quimicamente
Síndrome da Leucoencefalopatia Posterior/cirurgia
Pirimidinas/efeitos adversos
Sulfonamidas/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pyrimidines); 0 (Sulfonamides); 7RN5DR86CK (pazopanib)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170628
[Lr] Data última revisão:
170628
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE



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