title: Posterior Reversible Encephalopathy Syndrome in a Patient with Severe Uremia without Hypertension.
abstract: A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. Brain magnetic resonance imaging showed reversible vasogenic edema in the brainstem and bilateral frontal centrum semiovale. All of his neurological symptoms immediately improved after the introduction of hemodialysis. When a patient with uremia presents with neurological symptoms, posterior reversible encephalopathy syndrome should be considered in the differential diagnosis even if high blood pressure is not observed. Brain magnetic resonance imaging may be helpful in such a case, and an appropriate therapy could be subsequently initiated.
authors.affiliation: Department of Internal Medicine, Koseiren Sanjo General Hospital, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Iwafuchi
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Oyama
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001929:Brain Edema / Q000209:etiology; D001933:Brain Stem / Q000473:pathology; D003937:Diagnosis, Differential; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000628:therapy; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome; D014511:Uremia / Q000209:etiology* / Q000628:therapy
chemical_list: D000959:Antihypertensive Agents