A case of posterior reversible encephalopathy syndrome after plasma exchange for severe IgA vasculitis

Taira Shogo, Terukina Shigetomo, Adachi Takayuki, Tamayose Shiori, Kikumura Tasuku, Nagayama Kiyomitu, Nishihira Morikuni, Oroku Masato, Shimoji Kunihiro, Shiohira Yoshiki, Iseki Kunitoshi

doi:10.4009/jsdt.52.491

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Other Title

重症IgA血管炎に対する血漿交換後に可逆性白質脳症をきたした1例
症例報告重症IgA血管炎に対する血漿交換後に可逆性白質脳症をきたした1例
ショウレイホウコクジュウショウ IgA ケッカンエンニタイスルケッショウコウカンゴニカギャクセイハクシツノウショウオキタシタ 1レイ

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<p>A 27-year-old female was admitted to hospital because of multi-joint pain and palpable purpura on both legs after an upper respiratory infection. Three days later, macroscopic hematuria and proteinuria were detected. IgA deposition in the skin, abnormal gastric histopathological findings, and endocapillary proliferative glomerulonephritis with IgA deposition in the mesangial region were observed. The patient was diagnosed with IgA vasculitis. Intravenous steroid pulse therapy was ineffective; therefore, plasma exchange and an immunosuppressant were added. The day after 3 rounds of plasma exchange had been performed, a systemic tonic-clonic seizure occurred. Multiple white-matter lesions of the cerebral cortex were found on magnetic resonance imaging after the convulsion, but they had disappeared 16 days after the seizure. Thus, the patient was diagnosed with posterior reversible encephalopathy syndrome. We reported a case of posterior reversible encephalopathy syndrome caused by various factors, such as IgA vasculitis, immunosuppressive treatment, and plasma exchange for nephrotic syndrome.</p>

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 52 (8), 491-496, 2019

The Japanese Society for Dialysis Therapy

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