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Posterior reversible leukoencephalopathy syndrome in children with hematologic disorders
OBJECTIVE: : Posterior reversible leukoencephalopathy syndrome (PRES) is characterized by headache, altered mental status, cortical blindness, and seizures associated with neuroradiological findings. It involves predominantly white matter of the parieto-occipital lobes. Several medications and disorders play a role in the etiology of PRES. In this study, we aimed to show how the prognosis of PRES in hematological diseases of childhood might be according to the etiological factors.METHODS: Here, we report PRES in six patients, aged 4 to 14 years, with diagnoses of leukemia and aplastic anemia. RESULTS: Suggested causes in our patients were chemotherapeutics, hypertension, infection and antimicrobial drug administration, tumor lysis syndrome, acute renal failure and hemodialysis, immunosuppressive drug administration, and hypomagnesemia. One of the patients died of sepsis, renal failure and pulmonary hemorrhage and another died of relapse after total recovery from PRES. The other four patients are under follow-up without problems.CONCLUSION: We suggest that PRES can recover fully with early diagnosis and treatment whereas it can show poor prognosis depending on the etiology.

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Authors: Barış Malbora, Zekai Avcı, Fulden Dönmez, Bülent Alioğlu, Esra Baskın, Füsun Alehan, Namık Özbek

Keywords: Akut lösemi, aplastik anemi, posterior geri dönüşümlü lökoensefalopati sendromu, tümör lizis sendromu

  • Year: 2010
  • Number: 3
  • Referance No: 62681
  • Figure 1. There are hyperintensities on both frontal and parietal white matter, consistent with vasogenic edema on initial axial FLAIR image (A). There are also similar signal changes in temporal lobes (not shown). On follow-up MRI, the FLAIR image shows regression of the edema at the frontal and parietal lobes (B)
  • Figure 2. Axial initial FLAIR image shows mild signal increase on the frontal and parietal lobes (A). On follow-up MRI, FLAIR images show severe progression of the lesions on bilateral frontal, parietal and temporal lobes and new lesions are seen on bilateral cerebellar hemispheres (B,C)

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