Severe Aplastic Anemia Complicated by Posterior Reversible Encephalopathy Syndrome

Endo Ayumi, Shichino Hiroyuki, Chin Motoaki, Fukuhara Junji, Kato Maiko, Ryo Naohiro, Mugishima Hideo

doi:10.4264/numa.68.211

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Ｐｏｓｔｅｒｉｏｒ　Ｒｅｖｅｒｓｉｂｌｅ　Ｅｎｃｅｐｈａｌｏｐａｔｈｙ　Ｓｙｎｄｒｏｍｅを合併した最重症型再生不良性貧血の一女児例
症例報告 Posterior Reversible Encephalopathy Syndromeを合併した最重症型再生不良性貧血の一女児例
ショウレイホウコク Posterior Reversible Encephalopathy Syndrome オガッペイシタサイジュウショウガタサイセイフリョウセイヒンケツノ 1ジョジレイ

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Abstract

Herein, we report a 6-year-old girl who developed Posterior Reversible Encephalopathy Syndrome (PRES) after stem cell transplantation (SCT) for severe aplastic anemia. She had received Cyclosporine A (CsA) for prophylaxis of graft versus host disease (GVHD). On day 22 after transplantation, she experienced generalized seizure and consciousness disturbance. Prior to the onset, she exhibited hypertension, oliguria and headache. Brain MRI showed abnormal, bilateral high-intensity areas in the parieto-occipital white matter lesions on T2-weighted images and fluid-attenuated inversion recovery (FLAIR) images. We diagnosed her as PRES. CsA was immediately withdrawn, and her condition improved. Thereafter, She developed grade III acute GVHD, which was treated with tacrolimus with no adverse effects. This case suggests that if symptoms, such as headache and hypertension, appear with the use of CsA, it is important to examine head MRI at an early stage and to consider the possible presence of PRES.

Journal

Journal of Nihon University Medical Association

Journal of Nihon University Medical Association 68 (3), 211-214, 2009

NIHON UNIVERSITY MEDICAL ASSOCIATION

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