Reversible posterior leukoencephalopathy syndrome caused by blood transfusion: a case report.
This is a case report of a 32-year-old woman with chronic severe anemia who developed headaches and seizures 5 days after receiving a blood transfusion of eight units (1600 ml) of packed red blood cells. Magnetic resonance imaging indicated vasogenic edematous lesions bilaterally over the occipital lobes that were consistent with reversible posterior leukoencephalopathy syndrome (RPLS). Her blood pressure was normal, and no other contributing factors for RPLS were found. It is likely that the initiator was the large volume of transfused blood, which disrupted cerebral autoregulation and damaged the vasculoendothelial system. Similar cases of RPLS following transfusion have been reported, and all reports involved middle-aged females with chronic severe anemia who received large volumes of transfused blood within a short period of time. Although blood transfusion is a common procedure with rare neurological complications, great caution should be taken with chronic severely anemic patients because a rapid elevation in hemoglobin may precipitate RPLS.
Huang
Yung-Chuan
YC
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Tsai
Pei-Lin
PL
Yeh
Jiann-Horng
JH
Chen
Wei-Hung
WH
D000328:Adult; D000740:Anemia / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000473:pathology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009778:Occipital Lobe / Q000473:pathology*; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D012640:Seizures / Q000209:etiology; D065227:Transfusion Reaction