Posterior reversible encephalopathy syndrome—Insight into pathogenesis, clinical variants and treatment approaches

Granata, Guido; Greco, Antonio; Iannella, Giannicola; Granata, M; Manno, Alessandra; Savastano, Ersilia; Magliulo, Giuseppe

doi:10.1016/j.autrev.2015.05.006

Cited by 158 publications

(151 citation statements)

References 63 publications

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“…Posterior reversible encephalopathy syndrome (PRES) in a clinicoradiological entity caused by subcortical vasogenic edema, which leads to symptoms such as headaches, altered consciousness, seizures, and visual disturbances [167]. It can occur as a result of conditions such as eclampsia, hypertensive encephalopathy, and intense immunosuppression [168].…”

Section: Posterior Reversible Encephalopathy Syndromementioning

confidence: 99%

“…Lowering and adequate monitoring of blood pressure is a sine qua non for all cases, while epileptic seizures should preferably be treated with rapidly effective IV agents. Removal of the underlying cause is necessary [167]. As hypertensive and immunosuppression related PRES is more common, patients with SLE and vasculitis with relevant CNS symptoms should be carefully evaluated.…”

Section: Posterior Reversible Encephalopathy Syndromementioning

confidence: 99%

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Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

et al. 2016

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Neurological involvement is relatively common in the majority of systemic autoimmune diseases and may lead to severe morbidity and mortality, if not promptly treated. Treatment options vary greatly, depending on the underlying systemic pathophysiology and the associated neurological symptoms. Selecting the appropriate therapeutic scheme is further complicated by the lack of definite therapeutic guidelines, the necessity to differentiate primary neurological syndromes from those related to the underlying systemic disease, and to sort out adverse neurological manifestations caused by immunosuppressants or the biological agents used to treat the primary disease. Immunotherapy is a sine qua non for treating most, if not all, neurological conditions presenting in the context of systemic autoimmunity. Specific agents include classical immune modulators such as corticosteroids, cyclophosphamide, intravenous immunoglobulin, and plasma exchange, as well as numerous biological therapies, for example antitumor necrosis factor agents and monoclonal antibodies that target various immune pathways such as B cells, cytokines, and co-stimulatory molecules. However, experience regarding the use of these agents in neurological complications of systemic diseases is mainly empirical or based on small uncontrolled studies and case series. The aim of this review is to present the state-of-the-art therapies applied in various neurological manifestations encountered in the context of systemic autoimmune diseases; evaluate all treatment options on the basis of existing guidelines; and compliment these data with our personal experience derived from a large number of patients.

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Section: Posterior Reversible Encephalopathy Syndromementioning

confidence: 99%

Section: Posterior Reversible Encephalopathy Syndromementioning

confidence: 99%

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

et al. 2016

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“…Generell herrscht Konsensus darüber, dass normotensive Werte anzustreben sind [9,10,18]. Allerdings gibt es bisher noch keinen Nachweis aus prospektiven Studien für einen Zusammenhang zwischen der Behandlung hypertensiver Episoden und der Rückbildung neurologischer Symptome.…”

Section: Therapieunclassified

Das posteriore reversible Enzephalopathiesyndrom

Fischer

Schmutzhard

2016

Med Klin Intensivmed Notfmed

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“…Neurological complications, such as posterior reversible encephalopathy syndrome (PRES), are relatively common in patients with CRF and ~45% of the reported kidney disease cases exhibit comorbidity with PRES (2).…”

Section: Introductionmentioning

confidence: 99%

“…PRES is a well-known reversible neuroradiological clinical entity characterized by symptoms including headaches, nausea and vomiting, seizures, alterations in consciousness, vision changes, cortical blindness and other focal neurologic symptoms and signs (2). The incidence of PRES is moderately higher in females than in males (male:female ratio is 0.8:1) and the mean age at presentation is 44 years with an extended age range of 14 to 78 years (2).…”

Section: Introductionmentioning

confidence: 99%

The clinical characteristics of posterior reversible encephalopathy syndrome in patients with chronic renal failure

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Few studies have investigated posterior reversible encephalopathy syndrome (PRES) in patients with chronic renal failure (CRF). The present study analyzed the clinical manifestations, laboratory examinations and imaging features of PRES in patients with CRF. A total of 42 patients with CRF with or without PRES were recruited in the current retrospective case-control study. Patient data taken prior to the onset of PRES in patients with CRF and PRES (n=21) were collected and analyzed. At the same time, data from patients with CRF but without PRES (n=21) were also analyzed. Brain magnetic resonance imaging (MRI) scans were collected from patients in the PRES group. The mean blood pressure of patients in the PRES group was significantly higher than that of the control group (systolic blood pressure: 172±15 mmHg vs.

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Posterior reversible encephalopathy syndrome—Insight into pathogenesis, clinical variants and treatment approaches

Cited by 158 publications

References 63 publications

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

Das posteriore reversible Enzephalopathiesyndrom

The clinical characteristics of posterior reversible encephalopathy syndrome in patients with chronic renal failure

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