title: Posterior Reversible Encephalopathy Syndrome After Transplantation: a Review.
abstract: Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disease. Recently, an increase in the number of transplantations has led to more cases being associated with PRES than what was previously reported. Calcineurin inhibitors (CNIs) are major risk factors for PRES in posttransplantation patients. The mechanisms of the development of PRES remain to be unclear. The typical clinical symptoms of PRES include seizures, acute encephalopathy syndrome, and visual symptoms. The hyperintense signal on fluid-attenuated inversion recovery image is the characteristic of the imaging appearance in these patients. In addition, other abnormal signals distributed in multiple locations are also reported in some atypical cases. Unfortunately, PRES is often not recognized or diagnosed too late due to complicated differential diagnoses, such as ischemic stroke, progressive multifocal leukoencephalopathy, and neurodegenerative diseases. Thus, this review emphasizes the importance of considering the possibility of PRES when neurological disturbances appear after solid organ transplantation or hematopoietic cell transplantation. Moreover, this review demonstrates the molecular mechanisms of PRES associated with CNIs after transplantation, which aims to help clinicians further understand PRES in the transplantation era.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Dixon
authors.initials: D
authors.lastname: Brandon
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. airforce78@163.com.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China. airforce78@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China.|Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D006801:Humans; D008954:Models, Biological; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015995:Prevalence; D011379:Prognosis; D014180:Transplantation / Q000009:adverse effects*
keywords: Calcineurin inhibitors; Etiology; Physiopathology; Posterior reversible encephalopathy syndrome; Therapy; Transplantation