| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
a Department of
Neurological and Visual Sciences, University of Genova, Italy, b Department of Neuroradiology, Hospital San
Martino, Genova, Italy
Correspondence to: Dr L Cocito, Department of Neurological and Visual Sciences, University of Genova, Via A De Toni, 5 I-16132 Genova, Italy lcocito{at}neurologia.unige.it
Accepted for publication 9 October
2000
OBJECTIVES
Reversible
posterior leucoencephalopathy syndrome (RPLS) may develop in patients
with renal insufficiency, hypertension, and immunosuppression, and is
managed by prompt antihypertensive and anticonvulsant treatment. Four
patients with renal insufficiency and fluid overload associated with
Wegener's granulomatosis (one patient) and systemic lupus
erythematosus (SLE) (three patients) are described, whose clinical
picture and neuroimaging indicated RPLS.
CASE REPORTSAll
patients had headache, seizures, visual abnormalities, and transient
motor deficit, and were hypertensive at the onset of the symptoms. Head
computed tomography (CT) scan and magnetic resonance imaging showed
predominantly posterior signal abnormalities, which were more
conspicuous on T2 weighted spin echo images than on CT
scan. All patients had some form of cytotoxic treatment shortly before
the syndrome developed, and dramatically responded to blood pressure
control and anticonvulsant treatment. In two patients with SLE,
dialysis was required for renal insufficiency.
DISCUSSIONFollow up
neuroimaging studies showed almost complete resolution of signal
abnormalities, and suggested that RPLS was associated with cerebral
oedema without concomitant infarction. The treatment of hypertension
and neurotoxic condition such as uraemia appears of primary importance,
while immunosuppressive treatment may cause further damage of the
blood-brain barrier.
This article has been cited by other articles:
|
|
 |
|
  W.S. Bartynski Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1036 - 1042. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mak, B. P. L. Chan, I. B. Yeh, R. C. M. Ho, M. L. Boey, P. H. Feng, D. R. Koh, and B. K. C. Ong Neuropsychiatric lupus and reversible posterior leucoencephalopathy syndrome: a challenging clinical dilemma Rheumatology, March 1, 2008; 47(3): 256 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Leroux, J. Sellam, N. Costedoat-Chalumeau, D. Le Thi Huong, A. Combes, N. Tieulie, J. Haroche, Z. Amoura, A. Nieszkowska, J. Chastre, et al. Posterior reversible encephalopathy syndrome during systemic lupus erythematosus: four new cases and review of the literature Lupus, February 1, 2008; 17(2): 139 - 147. [Abstract] [PDF]
|
|
|
|
 |
|
 K. El Karoui, M. Le Quintrec, E. Dekeyser, A. Servais, A. Hummel, F. Fadel, and F. Fakhouri Posterior reversible encephalopathy syndrome in systemic lupus erythematosus Nephrol. Dial. Transplant., February 1, 2008; 23(2): 757 - 763. [Full Text] [PDF]
|
|
|
|
|
|
T. Zar, W. Samson, and J. Palmisano Reversible posterior leukoencephalopathy syndrome (RPLS) in a patient with systemic lupus erythematosus (SLE) and lupus nephritis Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2400 - 2401. [Full Text] [PDF]
|
|
|
|
|
|
M.L. Ishimori, B.D. Pressman, D.J. Wallace, and M.H. Weisman Posterior reversible encephalopathy syndrome: another manifestation of CNS SLE? Lupus, June 1, 2007; 16(6): 436 - 443. [Abstract] [PDF]
|
|
|
|
 |
|
 W L Poon and C C Mok Reversible posterior leucoencephalopathy in scleroderma Ann Rheum Dis, December 1, 2005; 64(12): 1803 - 1804. [Full Text] [PDF]
|
|
|
|
|
|
C. P. Mavragani, P. G. Vlachoyiannopoulos, N. Kosmas, I. Boletis, A. G. Tzioufas, and M. Voulgarelis A case of reversible posterior leucoencephalopathy syndrome after rituximab infusion Rheumatology, November 1, 2004; 43(11): 1450 - 1451. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
