No abstract

Rationale: Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disease of the posterior subcortical white matter that manifests as headache, seizures, visual impairment, disturbance of consciousness, and changes in mental state. While PRES is associated with specific imaging findings involving the posterior circulation area of the brain. In the present study, we report the first case of PRES associated with essential thrombocythemia (ET). Patient concerns: A 49-year-old man suddenly experienced headache, followed by the gradual appearance of consciousness disorders and mental behavior abnormalities. Neurological tests showed that the patient had a Glasgow Coma Scale score of 12, normal muscle strength and tension of the limbs, and was negative for meningeal irritation. Diagnosis: Magnetic resonance imaging of the brain showed extensive vasogenic edema in the deep white matter of the right cerebellum and the left occipital and temporal lobes and a diagnosis of PRES was considered. Routine blood test showed that his platelet count was markedly increased, and the JAK2 V617F mutation analysis with allele-specific real-time polymerase chain reaction was positive. The bone marrow biopsy indicated an increasing number of megakaryocytes. These findings indicated ET. Interventions: PRES was treated with a dehydrating agent and supportive and symptomatic treatments. Aspirin tablets were prescribed to address the patient's ET. Outcome: After treatment, the abnormal findings on head imaging were completely reversed. His neurological symptoms were completely relieved. Lessons: PRES may be correlated with ET; specifically, ET may trigger PRES and be a risk factor for the acute onset of neurological deficits.

Objective: Previous studies have reported differences between adolescent-depression and adult- onset depression with respect to demographic and clinical symptoms. However, it remains unclear whether these sex and age of onset differences can be detected in regular scales based on symptom traits. The comparition of symptoms between early-onset (male/female) and late-onset (male/female) Chinese MDD patients was performed in the present study. Methods/Study protocol: The present cross-sectional study was conducted in the psychiatric department of the sixth affiliated hospital at Kunming Medical University from Sep 2020 to Mar 2022. We recruited 229 outpatients with a first diagnosis of MDD .Two groups differed on seven-dimensional symptoms on the Hamilton Depression Rating Scale (HAMD-24) in addition, correlations between seven-dimensional symptoms were compared across two groups.Principal components analysis (PCA) was conducted to assess sex, SAS and SDS differences between two groups. Results: 1.Early-onset cases have a high score in Hopelessness score (p=0.049), whereas females have a higher score in Anxiety somatization score (p=0.005) and sleep disturbances（p=0.007），There was no significant symptom difference in symptoms between the groups and other symptoms. 2.female(p＜0.01) and early-onset（p＜0.05）are risk factors for hopelessness in MDD, female（p＜0.05）is a risk factor of sleep disturbances in late-onset MDD, early-onset（p＜0.05）is a risk factor of cognitive impairment restrict in female in MDD. 3.we found no significant goodness of fit and predictive power in 4 groups categorized by year of onset. Conclusion: larger samples sizes in different regions and time periods with targeted cognitive questionnaire are warranted to redress the new nosology in early-onset MDD based on DUI in additional studies2.Late-onset female patients show less cognitive impairment and more sleep disorder.3.the female and early onset year are risk factors in the hopelessness score in cases of MDD. Trial entry: China Clinical Trials.gov 908236120030