Posterior Reversible Encephalopathy Syndrome (PRES) in 5-year-old girl with nephrotic syndrome.
OBJECTIVE
Posterior Reversible Encephalopathy Syndrome (PRES) is a rare complication of nephrotic syndrome in children. This clinical condition is caused by localized brain angioedema mostly in parieto-occipital region and results in dramatic and acute features as sudden loss of consciousness, epileptic paroxysms, strong headache or visual disturbances. Uncontrolled hypertension often participates in PRES development.


METHODS
We present the case of a 5-year-old girl treated for relapse of nephrotic syndrome.


RESULTS
At the time of edema regression and weight reduction, a sudden loss of consciousness and worsening of hypertension occurred. Brain MRI demonstrated extended multifocal changes strongly suspicious of encephalitis. After exclusion of herpetic encephalitis, the clinical picture was classified as PRES. Successful antihypertensive treatment led to general improvement of the girl's health within 48 hours and resolution of MRI brain hyperintensities occurred within the next three months.


CONCLUSIONS
The aim of our case report is to us remind of possible development of PRES at the time of edema regression in nephrotic syndrome.
Kabicek
Pavel
P
Department of Pediatrics and Adolescent Medicine, General University Hospital and 1st Faculty of Medicine, Charles University Prague, Czech Republic. p.kabicek@post.cz
Sulek
Stepan
S
Seidl
Zdenek
Z
Vaneckova
Manuela
M
Kabickova
Edita
E
Vobruba
Vaclav
V
Wenchich
Laszlo
L
Zeman
Jiri
J
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy; D054038:Posterior Leukoencephalopathy Syndrome / Q000150:complications*
D000959:Antihypertensive Agents