Posterior leukoencephalopathy and nephrotic syndrome: just a coincidence?
Posterior leukoencephalopathy syndrome (PLES) is an acute neurological disorder. The most plausible hypothesis for the pathophysiology of PLES is the loss of autoregulation and consequent vasogenic edema. PLES is mostly attributed to severe or sudden elevations of arterial blood pressure. A number of reports, however, describe patients with PLES without severe hypertension. This report presents two patients with nephrotic syndrome who developed PLES without customarily severe hypertension. Proteinuria, low levels of serum albumin, or generalized increase in capillary permeability in nephrotic syndrome can initiate PLES with moderately high arterial blood pressure levels. PLES is increasingly recognized by neurologists, but it should also be remembered by internists when confronted with patients with nephrotic syndrome who present with neurological symptoms, whether or not they have severe hypertension.
Aksoy
Duygu Yazgan
DY
Departments of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. dcemaksoy@hotmail.com
Arici
Mustafa
M
Kiykim
Ahmet Alper
AA
Durusu
Mine
M
Sahin
Gurdal
G
Baydar
Dilek Ertoy
DE
Altun
Bulent
B
Erdem
Yunus
Y
Yasavul
Unal
U
Turgan
Cetin
C
Caglar
Sali
S
D000328:Adult; D001927:Brain Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications*