title: Reversible posterior leukoencephalopathy syndrome after blood transfusion in a pediatric patient with sickle cell disease.
abstract: BACKGROUND
  Children with sickle cell disease are at increased risk for neurological complications. Reversible posterior leukoencephalopathy syndrome is a clinico-radiological syndrome characterized by headache, vomiting, seizures, and visual disturbances along with the radiological findings of posterior leukoencephalopathy.
  
  
  METHODS
  We report a 13-year-old female with sickle cell disease presenting with a headache and two isolated episodes of partial seizures with secondary generalization after blood transfusion. The brain MRI revealed bilateral high signal areas on T2 images in parietal, occipital, and frontal lobes; in the cerebellum; midbrain; and within the right caudate nucleus. Follow-up MRI 2 weeks later showed almost complete resolution of the previously detected findings. The clinical presentation along with the reversible aforementioned neuroimaging findings indicated reversible posterior leukoencephalopathy syndrome as the most appropriate diagnosis. Although the syndrome has been described previously in various clinical conditions, this is the first time that it is recognized after blood transfusion in an adolescent with sickle cell disease.
  
  
  CONCLUSIONS
  Neurological deterioration in children with sickle cell disease after blood transfusion should raise high suspicion for reversible posterior leukoencephalopathy syndrome, especially in the setting of elevated blood pressure.
authors.affiliation: Department of Pediatrics, University Hospital of Patras, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kolovou
authors.forename: Peter
authors.initials: P
authors.lastname: Zampakis
authors.forename: Afroditi
authors.initials: A
authors.lastname: Ginopoulou
authors.forename: Anastasia
authors.initials: A
authors.lastname: Varvarigou
authors.forename: Joseph
authors.initials: J
authors.lastname: Kaleyias
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000628:therapy*; D005260:Female; D006801:Humans; D054038:Posterior Leukoencephalopathy Syndrome / Q000209:etiology*; D065227:Transfusion Reaction