title: Posterior reversible encephalopathy syndrome complicating diabetic ketoacidosis; an important treatable complication.
abstract: Development of acute neurological symptoms secondary to cerebral oedema is well described in diabetic ketoacidosis (DKA) and often has a poor prognosis. We present the clinical and radiological data of a 17-yr-old girl who developed cortical blindness, progressive encephalopathy, and seizures caused by posterior reversible encephalopathy syndrome (PRES) that developed after her DKA had resolved. Vasogenic oedema in PRES resolves if the underlying trigger is identified and eliminated. In this case, hypertension was identified as the likely precipitating factor and following treatment her vision and neurological symptoms rapidly improved. We suggest how recent DKA may have contributed to the development of PRES in this patient.
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Jones
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Kasey
authors.initials: K
authors.lastname: Redler
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Witherick
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Geraint
authors.initials: G
authors.lastname: Fuller
authors.affiliation: Department of Diabetes, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Tripti
authors.initials: T
authors.lastname: Mahajan
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Wakerley
mesh_terms: D000293:Adolescent; D019575:Blindness, Cortical / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001929:Brain Edema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D004573:Electrolytes / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007741:Labetalol / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D054038:Posterior Leukoencephalopathy Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*
chemical_list: D004573:Electrolytes; D007741:Labetalol
keywords: diabetic ketoacidosis; hypomagnesaemia; posterior reversible encephalopathy syndrome