Recurrent Posterior Reversible Encephalopathy Syndrome in a Child With Microscopic Polyangiitis

Wang, Stephani C.; Habib, Sabeen; Umer, Sarwat; Reisman, Lewis; Raman, Vidya

doi:10.1097/rhu.0000000000000222

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…The lung is the most commonly affected organ in MPA. Chest CTs show diffuse areas of ground-glass opacity ( 11 ), reticulation ( 12 ), patchy shadows ( 13 ), nodular thickening ( 14 ), interstitial pneumonia ( 15 ), emphysema ( 16 ), and pleural effusion ( 17 ). The lesions are always of a symmetric distribution, and all these changes could be alone or coexist in one patient.…”

Section: Discussionmentioning

confidence: 99%

“…Normal X-rays do not mean the lungs are unaffected ( 18 ), and most patients will be required to have a chest CT. MPA can also involve the nervous system. Magnetic resonance imaging (MRI) of the brain revealed non-hemorrhagic multiple lesions ( 13 ), reversible posterior leukoencephalopathy syndrome ( 16 ), and even hemorrhagic stroke ( 19 ). We recommend that brain MRI be performed on patients diagnosed with, or suspected of having, MPA.…”

Section: Discussionmentioning

confidence: 99%

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Microscopic polyangiitis presenting with persistent cough and hemoptysis in pediatrics: A case report and review of the literature

Zhu

Zheng

2022

Front. Oncol.

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BackgroundMicroscopic polyangiitis (MPA) is a necrotizing vasculitis that involves small- and medium-sized vessels and is associated with the presence of antineutrophil cytoplasmic antibodies with a perinuclear staining pattern (p-ANCA). The kidney and lungs are the organs primarily affected. MPA is rare in children and is easily misdiagnosed. Below is a complete case history of the course of the disease.Case presentationAn 11-year-old girl with a 1-month history of cough and hemoptysis showed no improvement after imipenem-cilastatin treatment. p-ANCA and microscopic hematuria and proteinuria were positive, and a chest CT revealed an area of shadow in the bilateral lower lobe of the lungs. Renal biopsies showed crescentic glomerulonephritis, and MPA was diagnosed based on these criteria. The patient exhibited dramatic clinical and imaging improvements after immunosuppressive treatment.ConclusionThe organs most commonly involved in MPA in children are the lungs, kidneys, skin, nervous system organs, and organs of the gastrointestinal tract. Careful examination should be carried out in these patients while biopsies of the kidney or any other organs remain the gold standard for diagnostic purposes. Pulmonary involvement may be the initial symptom of the disease and should not be confused with pneumonia. A urinalysis should be performed in patients with hemoptysis. Antibiotics should be used with caution.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Microscopic polyangiitis presenting with persistent cough and hemoptysis in pediatrics: A case report and review of the literature

Zhu

Zheng

2022

Front. Oncol.

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“…There was a small number of cases of AAV complicated by PRES. Seven cases with P-ANCA-or MPO-ANCA-associated MPA (four from the English literature (15)(16)(17)(18) and three from Japanese literature (19,20)) were reported in detail (Table 3). At the onset of PRES, six patients were using corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

A Young Patient with Microscopic Polyangiitis Requiring Hemodialysis with Complications of Repeated Episodes of Posterior Reversible Encephalopathy Syndrome Probably Due to Different Etiologies

Asakawa

Arai

et al. 2022

Intern. Med.

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A young woman with microscopic polyangiitis (MPA) requiring hemodialysis showed repeated posterior reversible encephalopathy syndrome (PRES) with spatiotemporal multiple lesions over a period of two months. The first PRES episode with confusion and the second PRES episode with vertigo and nausea were caused by MPA, hypertension and renal failure. These symptoms were improved by the reinforcement of MPA treatment and blood pressure management. The third PRES episode with nausea, headache, seizure and visual changes was induced by rituximab infusion and hypertension. The PRES was improved with blood pressure and convulsant management. These conditions are challenging to diagnose and treat.

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Posterior Reversible Encephalopathy Syndrome in a Patient With Microscopic Polyangiitis: A Case Report and Literature Review

Ding

et al. 2021

Front. Med.

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Central nervous system (CNS) is rarely involved in microscopic polyangiitis (MPA). Here, we report a 14-year-old girl with MPA who developed new-onset seizures with deterioration of renal function. Her brain CT scan and MRI showed concurrent complications of intracerebral hemorrhage and posterior reversible encephalopathy syndrome (PRES). She got remission with combinations of methylprednisolone pulse, plasma exchange, regular hemodialysis, antiseizure and antihypertension medications. Furthermore, it is crucial to exclude the adverse effect of medications such as corticosteroid and biological therapy. We searched the literatures, retrieved 6 cases of MPA with PRES and summarized their clinical characteristics.

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Recurrent Posterior Reversible Encephalopathy Syndrome in a Child With Microscopic Polyangiitis

Cited by 3 publications

References 7 publications

Microscopic polyangiitis presenting with persistent cough and hemoptysis in pediatrics: A case report and review of the literature

Microscopic polyangiitis presenting with persistent cough and hemoptysis in pediatrics: A case report and review of the literature

A Young Patient with Microscopic Polyangiitis Requiring Hemodialysis with Complications of Repeated Episodes of Posterior Reversible Encephalopathy Syndrome Probably Due to Different Etiologies

Posterior Reversible Encephalopathy Syndrome in a Patient With Microscopic Polyangiitis: A Case Report and Literature Review

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