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Prognostic factors in children with PRES and hematologic diseases
Author(s) -
Tambasco N.,
Mastrodicasa E.,
Salvatori C.,
Mancini G.,
Romoli M.,
Caniglia M.,
Calabresi P.,
Verrotti A.
Publication year - 2016
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12570
Subject(s) - posterior reversible encephalopathy syndrome , medicine , pediatrics , disease , neuroimaging , transplantation , encephalopathy , hypertensive encephalopathy , magnetic resonance imaging , surgery , radiology , psychiatry , blood pressure
Objectives Posterior reversible encephalopathy syndrome ( PRES ) is a clinical and radiological entity characterized by focal neurological signs, headache, confusion, and seizure, associated with transitory lesions in the posterior areas of the brain detectable with neuroimaging. Among children, one of the most common causes of PRES is cancer. Materials and Methods In this review, we present the cases of 5 children developing PRES after stem cell transplantation for hematological disease and review all the cases reported in English literature to investigate outcomes and associated risk factors. Results One hundred and eleven cases were reported. Hypertension was very frequent (80%). Clinical features included seizures (80.1%), headache (44.1%), visual disturbance (26.1%), and mental change (48.6%). EEG was abnormal in 27 of 32 patients. MRI revealed characteristic lesions in all patients even in early stages. Abnormal MRI findings in late stages were associated with neurological sequelae. Nineteen patients died (17.1%) of which 2 of PRES . Among alive patients, 17 had neurological sequelae. Four cases of PRES relapse were described. Conclusions Thus, all transplant recipients with symptoms consistent with PRES should be promptly recognized to avoid long‐term complications or even death.