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Posterior reversible encephalopathy syndrome associated with focal segmental glomerulosclerosis in a child
  1. Nadine Nassar1,2,
  2. Charbel Chater2,3 and
  3. Amal Chelala1,2
  1. 1Department of Radiology, Notre Dame des Secours University Hospital Center, Jbeil, Mont-Liban, Lebanon
  2. 2Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
  3. 3Department of General Surgery, Notre Dame des Secours University Hospital Center, Jbeil, Mont-Liban, Lebanon
  1. Correspondence to Dr Charbel Chater; charbeliban{at}hotmail.com

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare neurological entity, typically manifested by reversible oedema in the parieto-occipital lobes. It is usually associated with primary hypertension, autoimmune diseases and immunosuppressants. Renal disease is an uncommon cause of PRES. We report a case of an 11-year-old boy with STimulator of INterferon Genes-associated vasculopathy with onset in infancy complicated by focal segmental glomerulosclerosis leading to hypertension and PRES. The patient presented with headache, acute bilateral visual loss and hypertension. Brain MRI showed atypical features revealed by parieto-occipital haemorrhage. The child improved few days after antihypertensive therapy. Follow-up MRI showed complete resolution of haemorrhage. It is important to keep high index of suspicion for the uncommon association of PRES with underlying kidney disease with or without immunosuppressive agents. This combination is the first to our knowledge to be described in paediatric population. Atypical MRI features such as haemorrhage should be kept in mind. Symptoms are reversible within days to weeks with early diagnosis and treatment.

  • radiology
  • neuroimaging

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Footnotes

  • Contributors NN has contributed in planning, reporting, conception, design, acquisition and analysis of data. CC and AC have contributed in planning, reporting, conception, design, analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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