title: Post-streptococcal glomerulonephritis leading to posterior reversible encephalopathy syndrome: a case report.
abstract: BACKGROUND
  Posterior reversible encephalopathy syndrome is a clinical radiographic syndrome of heterogeneous etiologies. Developing hypertensive encephalopathy following post-streptococcal glomerulonephritis is a known but uncommon manifestation and developing posterior reversible encephalopathy syndrome in such a situation is very rare. We report a case with contrast-enhanced computed tomography and magnetic resonance imaging findings of posterior reversible encephalopathy syndrome in the background of acute post-streptococcal glomerulonephritis.
  
  
  METHODS
  A thirteen-year-old Sri Lankan boy presented with a focal fit by way of secondary generalization with duration of 10 minutes, and developed 2 similar fits subsequently following admission. He later developed severe hypertension with evidence of glomerulonephritis, which was diagnosed as acute post-streptococcal glomerulonephritis. A contrast-enhanced computed tomography imaging of brain done on day-3 revealed non-enhancing low-attenuating areas in fronto-parietal regions. A T2 weighted film of magnetic resonance imaging was done on day-10 of the admission and found to have linier sub-cortical hyper intensities in both parietal regions which were compatible with the radiological diagnosis of posterior reversible encephalopathy syndrome.
  
  
  CONCLUSIONS
  Post-streptococcal glomerulonephritis is an important cause of acute nephritic syndrome especially in children. This case report illustrates a rare association of posterior reversible encephalopathy syndrome in a patient with post-streptococcal glomerulonephritis.
authors.affiliation: Colombo North Teaching Hospital, Ragama, Sri Lanka. maduranew@yahoo.com.
authors.forename: Madura
authors.initials: M
authors.lastname: Adikari
authors.forename: Dilani
authors.initials: D
authors.lastname: Priyangika
authors.forename: Indika
authors.initials: I
authors.lastname: Marasingha
authors.forename: Sharmila
authors.initials: S
authors.lastname: Thamotheram
authors.forename: Gayani
authors.initials: G
authors.lastname: Premawansa
mesh_terms: D000293:Adolescent; D003287:Contrast Media; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D005921:Glomerulonephritis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011237:Predictive Value of Tests; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media