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Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura

Year 2016, Volume: 47 Issue: 3, 0 - 0, 01.09.2016
https://doi.org/10.16948/zktb.72866

Abstract

Introduction: Henoch–Schönlein purpura (HSP) is an acute vasculitis that primarily affects children. Central nervous system (CNS) involvement and the appearance of neurological complications preceding the characteristic rash are rare. Posterior reversible encephalopathy syndrome (PRES) and cerebral vasculitis are neurological complications of HSP.

Case presentation: We describe the case of a 5-year-old girl who presented with seizures, loss of consciousness, and total loss of vision. Her HSP was atypical because the presenting symptoms were neurological complications rather than the characteristic rash, and her radiological features were compatible with PRES. She did not have renal impairment or hypertension. Her abnormal findings resolved following a standard course of corticosteroids.

Conclusion: Our case is atypical because CNS involvement occurred before the characteristic rash in the absence of hypertension. The patient’s HSP presented as a complication of cerebral vasculitis.

References

  • References
  • Saulsbury FT. Henoch–Schönlein purpura in children. Report of 100 patients and review of the literature. Medicine (Baltimore).1999;78: 395–409.
  • Ha T-S, Cha S-H . Cerebral vasculitis in Henoch Schönlein purpura: A case report with sequential magnetic resonance imaging. Paediatr Nephrol.1996;10: 634-36
  • Woolfenden AR, Hukin J, Poskitt KJ, Connolly MB. Encephalopathy complicating Henoch–Schönlein purpura: reversible MRI changes. Pediatr Neurol. 1998; 19: 74-77.
  • Bérubé MD, Blais N, Lanthier S. Neurologic manifestations of Henoch-Schönlein purpura. Handb Clin Neurol. 2014;120: 1101-1111.
  • Sasayama D, Shimojima Y, Gono T et al. Henoch– Scho¨nlein purpura nephritis complicated by reversible posterior leukoencephalopathy syndrome. Clin Rheumatol. 2007; 26: 1761–63.
  • Garzoni L, Vanoni F, Rizzi M, Simonetti GD, Goeggel Simonetti B, Ramelli GP, Bianchetti MG. (2009) Nervous system dysfunction in Henoch-Schonlein syndrome: systematic review of the literature. Rheumatology 48 :1524-1529.
  • Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996; 334:494-500.
  • Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 2008; 29: 1036–42.
  • Elinson P, Foster KW Jr, Kaufman DB. Magnetic resonance imaging of central nervous system vasculitis. A case report of Henoch-Schönlein purpura. Acta Paediatr Scand. 1990;79: 710-713.
  • Ozcakar ZB, Ekim M, Fitoz S et al. Hypertension induced reversible posterior leukoencephalopathy syndrome: a report of two cases. Eur J Pediatr. 2004; 163: 728–30.
  • Prasad N, Gulati S, Gupta RK, et al. Spectrum of radio- logical changes in hypertensive children with reversible posterior leucoencephalopathy. Br J Radiol 2007; 80: 422- 9.

Henoch schönlein purpurası ilişkili posterior reversible ensefalopati sendromu

Year 2016, Volume: 47 Issue: 3, 0 - 0, 01.09.2016
https://doi.org/10.16948/zktb.72866

Abstract

Giriş: Henoch-Schönlein purpurası (HSP) primer olarak çocukları etkileyen akut bir  vaskülittir. Merkezi sinir sistemi (MSS) tutulumu ve karakteristik döküntülerden  önce nörolojik komplikasyonların ortaya çıkması nadirdir. Posterior reversibl ensefalopati sendromu (PRES) ve serebral vaskülit HSP nın  nörolojik komplikasyonlarıdır.

Olgu sunumu: konvülziyon, bilinç kaybı ve total görme kaybı ile başvuran 5 yaşındaki bir kız olgusu sunulmuştur. Nörolojik semptomlar ön planda olup, karekteristik döküntü yoktu. Radyolojik bulguları PRES ile uyumluydu. Klinik bulgular HSP için atipikti. Böbrek tutulumu ve hipertansiyon yoktu. Klinik bulgular kortikosteroid  tedavisi ile düzeldi.

Sonuç: Hastamız tipik HSP döküntülerinden önce santral sinir sistemi bulgularının ortaya çıkması ve hipertansiyonun olmaması nedeniyle ilginçtir. HSP nin santral sinir sistemi komplikasyonu ile başvurmuştur.

References

  • References
  • Saulsbury FT. Henoch–Schönlein purpura in children. Report of 100 patients and review of the literature. Medicine (Baltimore).1999;78: 395–409.
  • Ha T-S, Cha S-H . Cerebral vasculitis in Henoch Schönlein purpura: A case report with sequential magnetic resonance imaging. Paediatr Nephrol.1996;10: 634-36
  • Woolfenden AR, Hukin J, Poskitt KJ, Connolly MB. Encephalopathy complicating Henoch–Schönlein purpura: reversible MRI changes. Pediatr Neurol. 1998; 19: 74-77.
  • Bérubé MD, Blais N, Lanthier S. Neurologic manifestations of Henoch-Schönlein purpura. Handb Clin Neurol. 2014;120: 1101-1111.
  • Sasayama D, Shimojima Y, Gono T et al. Henoch– Scho¨nlein purpura nephritis complicated by reversible posterior leukoencephalopathy syndrome. Clin Rheumatol. 2007; 26: 1761–63.
  • Garzoni L, Vanoni F, Rizzi M, Simonetti GD, Goeggel Simonetti B, Ramelli GP, Bianchetti MG. (2009) Nervous system dysfunction in Henoch-Schonlein syndrome: systematic review of the literature. Rheumatology 48 :1524-1529.
  • Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996; 334:494-500.
  • Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 2008; 29: 1036–42.
  • Elinson P, Foster KW Jr, Kaufman DB. Magnetic resonance imaging of central nervous system vasculitis. A case report of Henoch-Schönlein purpura. Acta Paediatr Scand. 1990;79: 710-713.
  • Ozcakar ZB, Ekim M, Fitoz S et al. Hypertension induced reversible posterior leukoencephalopathy syndrome: a report of two cases. Eur J Pediatr. 2004; 163: 728–30.
  • Prasad N, Gulati S, Gupta RK, et al. Spectrum of radio- logical changes in hypertensive children with reversible posterior leucoencephalopathy. Br J Radiol 2007; 80: 422- 9.
There are 12 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section PEDIATRICS
Authors

Meltem Erol

Dilara Fucucuoğlu This is me

Özgül Yiğit This is me

Emine Erdoğan Kutanis This is me

Özlem Bostan Gayret

Ramazan Albayrak This is me

Publication Date September 1, 2016
Published in Issue Year 2016 Volume: 47 Issue: 3

Cite

APA Erol, M., Fucucuoğlu, D., Yiğit, Ö., Erdoğan Kutanis, E., et al. (2016). Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura. Zeynep Kamil Tıp Bülteni, 47(3). https://doi.org/10.16948/zktb.72866
AMA Erol M, Fucucuoğlu D, Yiğit Ö, Erdoğan Kutanis E, Bostan Gayret Ö, Albayrak R. Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura. Zeynep Kamil Tıp Bülteni. September 2016;47(3). doi:10.16948/zktb.72866
Chicago Erol, Meltem, Dilara Fucucuoğlu, Özgül Yiğit, Emine Erdoğan Kutanis, Özlem Bostan Gayret, and Ramazan Albayrak. “Posterior Reversible Encephalopathy Syndrome Associated With Henoch–Schönlein Purpura”. Zeynep Kamil Tıp Bülteni 47, no. 3 (September 2016). https://doi.org/10.16948/zktb.72866.
EndNote Erol M, Fucucuoğlu D, Yiğit Ö, Erdoğan Kutanis E, Bostan Gayret Ö, Albayrak R (September 1, 2016) Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura. Zeynep Kamil Tıp Bülteni 47 3
IEEE M. Erol, D. Fucucuoğlu, Ö. Yiğit, E. Erdoğan Kutanis, Ö. Bostan Gayret, and R. Albayrak, “Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura”, Zeynep Kamil Tıp Bülteni, vol. 47, no. 3, 2016, doi: 10.16948/zktb.72866.
ISNAD Erol, Meltem et al. “Posterior Reversible Encephalopathy Syndrome Associated With Henoch–Schönlein Purpura”. Zeynep Kamil Tıp Bülteni 47/3 (September 2016). https://doi.org/10.16948/zktb.72866.
JAMA Erol M, Fucucuoğlu D, Yiğit Ö, Erdoğan Kutanis E, Bostan Gayret Ö, Albayrak R. Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura. Zeynep Kamil Tıp Bülteni. 2016;47. doi:10.16948/zktb.72866.
MLA Erol, Meltem et al. “Posterior Reversible Encephalopathy Syndrome Associated With Henoch–Schönlein Purpura”. Zeynep Kamil Tıp Bülteni, vol. 47, no. 3, 2016, doi:10.16948/zktb.72866.
Vancouver Erol M, Fucucuoğlu D, Yiğit Ö, Erdoğan Kutanis E, Bostan Gayret Ö, Albayrak R. Posterior reversible encephalopathy syndrome associated with Henoch–Schönlein purpura. Zeynep Kamil Tıp Bülteni. 2016;47(3).