Posterior reversible encephalopathy syndrome: A conundrum of nephrotic syndrome complication
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Mohd Puad Munirah 1 , Noraini Mohamad 2 , Mohd Noor Norhayati 1 * , Azzahra Nurul Azman 3
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1 Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, MALAYSIA2 School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, MALAYSIA3 Department of Radiology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, MALAYSIA* Corresponding Author

Abstract

Nephrotic syndrome is a kidney disease with proteinuria, hypoalbuminemia, and edema. One rare, potentially life-threatening complication of nephrotic syndrome is posterior reversible encephalopathy syndrome (PRES). Sudden episodes of neurological symptoms such as headache, confusion, seizures, or focal neurological deficits with radiological findings of white matter abnormalities in the parietal and occipital lobes characterize it. Multiple factors predispose an individual with nephrotic syndrome to PRES, such as uncontrolled hypertension, reduced serum albumin levels, administration of drugs (cyclosporine, tacrolimus), anasarca, disturbed body fluid status and renal insufficiency. Here, we report a case of PRES in a seven-year-old girl with nephrotic syndrome who presented with high blood pressure while admitted to the ward. Her neurological symptom rapidly recovered after the control of hypertension. Recurrence of acute severe hypertension, nephrotic state (edema/ hypoalbuminemia), and renal insufficiency may lead to recurrent PRES. Thus, early treatment of trigger factors, especially of hypertension, is vital to reduce the episodes of PRES.

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Article Type: Case Report

ELECTRON J GEN MED, Volume 20, Issue 2, April 2023, Article No: em453

https://doi.org/10.29333/ejgm/12835

Publication date: 01 Mar 2023

Online publication date: 14 Jan 2023

Article Views: 1626

Article Downloads: 1190

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