title: Three cases of posterior reversible encephalopathy syndrome with chronic kidney disease triggered by infection.
abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological condition with diverse neurological manifestations. Many clinical factors are known causes of PRES, but only a few cases of PRES have been reported in patients with chronic kidney disease (CKD) and infectious disease. We describe three cases of PRES in patients with CKD triggered by various infectious diseases. Characteristic hyperintense signals on magnetic resonance imaging (MRI) indicating reversible vasogenic brain oedema in various parts of the brain were observed. To explain the pathophysiology of PRES, the hypertension/hyperperfusion and hypoperfusion/vasoconstriction theories have been proposed. Patients with CKD have many complications including uraemia, hypertension, and immunosuppression. Therefore, physicians should recognize that patients with CKD are at high risk of PRES triggered by infectious diseases and promptly diagnose PRES because immediate treatment of the triggers often leads to complete resolution.
authors.affiliation: Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kahori
authors.initials: K
authors.lastname: Nasu
authors.affiliation: Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kato
authors.affiliation: Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Masaomi
authors.initials: M
authors.lastname: Nangaku
mesh_terms: D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016871:Pasteurellaceae Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D054038:Posterior Leukoencephalopathy Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: chronic kidney disease; hypertension; infection; magnetic resonance imaging; posterior reversible encephalopathy syndrome