Pediatric Posterior Reversible Encephalopathy Syndrome (PRES) With Spinal Cord Involvement Due to Pheochromocytoma

Freedman, Daniel; Koram, A.; Gillson, Natalie; Aylward, Shawn C.

doi:10.1016/j.pediatrneurol.2017.06.016

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…PRES-SCI presentation is slightly different with the classical PRES (c-PRES) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Patients with PRES-SCI 2-23 seems to be younger than those within c-PRES with male predominance.…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome with spinal cord involvement

F¹,

Henry–Feugeas²,

Vidal‐Petiot³

et al. 2021

J Cardio Case Rep

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Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome with spinal cord involvement

F¹,

Henry–Feugeas²,

Vidal‐Petiot³

et al. 2021

J Cardio Case Rep

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“…A few case reports in the literature indicated that pheochromocytomas can lead to occurrence of RPLS (Table 1 ). [ 14 – 16 ] Large amounts of catecholamines are continuously or intermittently released by tumor cells, which can bring about secondary elevation of blood pressure with wide amplitude of fluctuation. A sudden change in blood pressure is likely to result in RPLS.…”

Section: Discussionmentioning

confidence: 99%

Reversible posterior leukoencephalopathy syndrome due to adrenal pheochromocytoma

Han

Tang

et al. 2020

Medicine

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Rationale: Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare neuropathic syndrome with typical clinical and radiological features. There are large amounts of risk factors resulting in RPLS, those including hypertension, eclampsia, neoplasia treatment, renal failure, systemic infections, chemotherapy, and immunosuppressive therapy after organ transplantation. Patient Concerns: A 27-year-old male patient was admitted for a 2-week history of paroxysmal tic of limbs along with consciousness disorder. Blood pressure elevation was discovered for the first time on admission, and the highest record was 210/150 mmHg during hospitalization. Neurological examinations were positive among mental state, speech, reaction and pathological reflex. The computed tomography scan of the abdomen demonstrated a mass derived from right adrenal gland. The magnetic resonance imaging of the brain showed reversible lesions in the centrum ovale, paraventricular, area and corpus callosum. Diagnoses: After control of blood pressure and rationally preoperative preparation, the mass was radically resected and verified to be pheochromocytoma by postoperative pathologic findings. He was diagnosed as having RPLS due to adrenal pheochromocytoma. Interventions: The right adrenal gland mass was completely removed after 2 weeks of α-blockers and β-blockers to treat hypertension. Outcomes: One week after surgery, the cerebral lesions of RPLS gradually faded and the blood pressure was easy to control well. Lessons: A few case reports of RPLS related to pheochromocytomas had been documented in the literature. Therefore, we believe that pheochromocytomas may be a potential risk factor of RPLS. If patients receive timely diagnosis and treatment, it can often lead to a favorable prognosis.

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“…31,73,120,[194][195][196][197][198][199] Solid organ malignancies reported contemporaneously with the development of PRES include brainstem ependymoma, 200 hepatoblastoma, 34 and pheochromocytoma. 201 Hematologic malignancies 18,25,39,[202][203][204][205] which may cause PRES in pediatric patients include acute lymphoblastic leukemia (ALL), 206 acute myeloblastic leukemia, 18 non-Hodgkin's lymphoma, 65 diffuse large B-cell lymphoma, 207 Burkitt's lymphoma, 39 anaplastic large cell lymphoma, 205 and hemophagocytic lymphohistiocytosis. 202 Other causes of PRES include, though not limited to, nonmalignant hematologic disease, 22,40 sickle cell anemia, 33 thalassemia, 22,208,209 essential thrombocythemia, 210 thrombotic thrombocytopenic purpura, 40 typical 211 and atypical 212 hemolytic uremic syndrome, blood transfusions, 32 infection, 38 connective tissue disorders and autoimmune disease, 32 pancreatitis, 213 electrolyte disturbances (e.g., hypomagnesemia, hypocalcemia, and hypercalcemia), licorice, 214 head trauma, 215 and eclamptic cerebrovascular dysautoregulation.…”

Section: Etiologymentioning

confidence: 99%

Etiologies, Cerebral Vasomotion, and Endothelial Dysfunction in the Pathophysiology of Posterior Reversible Encephalopathy Syndrome in Pediatric Patients

Ghali

Styler

2020

Journal of Pediatric Neurology

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The posterior reversible encephalopathy syndrome was characterized by Hinchey and colleagues in the 1990s. The condition frequently afflicts patients suffering from hematologic and solid organ malignancy and individuals undergoing transplantation. Cases are more frequently described in the adult population compared with children. In the pediatric population, malignancy, transplantation, renal disease, and hypertension represent the most common etiologies. Theories on pathogenesis have centered upon cerebrovascular dysautoregulation with increases in blood–brain barrier permeability. This generates vasogenic edema of the cerebral parenchyma and consequent neurologic deficits. The parietal and occipital lobes are affected with greatest prevalence, though frontal and temporal lobe involvement is frequent, and that of the contents of the infratentorial posterior cranial fossa are occasionally described. The clinical presentation involves a characteristic constellation of neurologic signs and symptoms, most typically inclusive of headache, visual-field disturbances, abnormalities of visual acuity, and seizures. Supportive care, withdrawal of the offending agent, antihypertensive therapy, and prophylactic anticonvulsants affect convalescence in majority of cases. The principal challenge lies in identifying the responsible agent precipitating the condition in patients with malignancy and those having undergone transplantation and thus deciding which medication among a multidrug treatment regimen to withhold, the duration of drug cessation required to effect clinical resolution, and the safety of resuming treatment with the compound. We accordingly reviewed and evaluated the literature discussing the posterior reversible encephalopathy syndrome in children.

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Pediatric Posterior Reversible Encephalopathy Syndrome (PRES) With Spinal Cord Involvement Due to Pheochromocytoma

Cited by 4 publications

References 5 publications

Posterior reversible encephalopathy syndrome with spinal cord involvement

Posterior reversible encephalopathy syndrome with spinal cord involvement

Reversible posterior leukoencephalopathy syndrome due to adrenal pheochromocytoma

Etiologies, Cerebral Vasomotion, and Endothelial Dysfunction in the Pathophysiology of Posterior Reversible Encephalopathy Syndrome in Pediatric Patients

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