title: Posterior reversible encephalopathy syndrome (PRES) with immune system activation, VEGF up-regulation, and cerebral amyloid angiopathy.
abstract: The case of a 75-year-old man with a history of lymphoma, recent upper respiratory tract infection, and a protracted course of encephalopathy is presented. Radiologically, findings were consistent with posterior reversible encephalopathy syndrome. A brain biopsy revealed evidence of endothelial activation, T-cell trafficking, and vascular endothelial growth factor expression, suggesting that systemic immune system activation may be involved with triggering posterior reversible encephalopathy syndrome. In addition, underlying cerebral amyloid angiopathy may have contributed to the initial nonclassical edema distribution by compromising autoregulatory blood flow mechanisms.
authors.affiliation: Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Kofler
authors.forename: Walter S
authors.initials: WS
authors.lastname: Bartynski
authors.forename: Thomas Q
authors.initials: TQ
authors.lastname: Reynolds
authors.forename: Frank S
authors.initials: FS
authors.lastname: Lieberman
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Murdoch
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D001706:Biopsy; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D001929:Brain Edema / Q000000981:diagnostic imaging* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D016657:Cerebral Amyloid Angiopathy / Q000000981:diagnostic imaging* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D015897:Comorbidity; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000000981:diagnostic imaging* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A