Blood transfusion‐induced posterior reversible encephalopathy syndrome presenting severe brain atrophy: A report of two cases

Shiraishi, Wataru

doi:10.1002/ccr3.5286

Clinical Case Reports

2022

DOI: 10.1002/ccr3.5286

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Blood transfusion‐induced posterior reversible encephalopathy syndrome presenting severe brain atrophy: A report of two cases

Wataru Shiraishi

Abstract: Several cases of posterior reversible encephalopathy syndrome (PRES) after blood transfusion have been reported, but the long‐term prognosis is unknown. Here, we report two cases of blood transfusion‐associated PRES with severe brain atrophy at 1 year after onset. We report the case with a discussion of pathological mechanisms.

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Cited by 3 publications

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Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes

Takigawa,

Shima,

Kubara

et al. 2024

Transfusion

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BackgroundPosterior reversible encephalopathy syndrome (PRES) is known as a transfusion‐related complication with typically favorable prognosis and no report fatalities. Pathological evaluation of PRES is also scarce.Case ReportAn 88‐year‐old female with myelodysplastic syndromes (MDS) attended our hospital because of a compression fracture and chronic heart failure with chronic anemia. While her hemoglobin levels improved from 4.6 to 8.0 g/dL and the pleural effusions substantially decreased following six units of red blood cell transfusion and diuretic therapy, a gradual decline in cognitive function and speech reduction was noted. PRES was diagnosed by magnetic resonance imaging of the head. Despite treatment of intensive supportive care, the patient fell into a coma by the 20th day and passed away on the 22nd day. Although the pathophysiological link between blood‐transfusion‐related PRES and its impact on survival is not fully understood, autopsy findings confirmed the diagnosis of PRES and revealed multiple cerebral hemorrhages that were not detected in earlier imaging studies.ConclusionThis case highlights the importance of vigilant monitoring and management of PRES, especially in high‐risk populations such as elderly patients with multiple comorbidities or those with thrombocytopenia. Further studies are needed to elucidate the mechanisms of PRES in patients with hematologic diseases.

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Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes

Takigawa,

Shima,

Kubara

et al. 2024

Transfusion

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Posterior Reversible Encephalopathy Syndrome (PRES) following blood transfusion in a polytrauma victim, an atypical occurrence

Shariff,

Soltan

2024

Turkish Journal of Emergency Medicine

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Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological syndrome, clinically present by impaired consciousness, headache, visual disturbances, and seizures, and radiologically brain edema. Cases of PRES induced by blood transfusion are rarely documented. We report this case to increase the awareness of treating physicians for the possible complications of rapid blood transfusion. A 29-year-old man presented with polytrauma and was in hemorrhagic shock. He was transfused with multiple transfusions. Later, he was found to have quadriplegia with minimal movement of fingers in the left hand. His computed tomography showed cerebral edema in multiple cerebral regions. We propose that the etiology in this case is that rapid blood transfusion induced acute rise in hemoglobin which led to PRES. The influences of blood transfusion on blood flow, blood viscosity, and endothelial dysfunction lead to blood–brain barrier dysfunction, which can result in PRES.

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Posterior Reversible Encephalopathy Syndrome Following Red Blood Cells Transfusion: A Case Report

Katiyar¹,

Katiyar²

2023

Indian Journal of Critical Care Case Report

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Posterior reversible encephalopathy syndrome (PRES) is a very infrequent disease characterized by alteration in mental status, which may lead to seizures and deficits. Here we describe a 42-year-old female with seizures after transfusion for chronic anemia. Her brain magnetic resonance imaging (MRI) showed edema in occipital regions consistent with the clinical finding. Many immunological and nonimmunological complications are present after blood transfusion, but PRES is rare and preventable.

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Blood transfusion‐induced posterior reversible encephalopathy syndrome presenting severe brain atrophy: A report of two cases

Cited by 3 publications

References 10 publications

Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes

Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes

Posterior Reversible Encephalopathy Syndrome (PRES) following blood transfusion in a polytrauma victim, an atypical occurrence

Posterior Reversible Encephalopathy Syndrome Following Red Blood Cells Transfusion: A Case Report

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