Reversible posterior encephalopathy syndrome in children with nephrotic syndrome

• DOI: 10.1111/nep.12518
• Publication Date: 2015-05-25T20:37:39Z
• Authors: Juan Zhou; Helin Zheng; Xuefei Zhong; Daoqi Wu; Mo Wang; Xuemei Tang; Qiu Li
• Keywords: Male; Nephrotic Syndrome; Time Factors; Calcineurin Inhibitors; Hypercholesterolemia; Age Factors; Electroencephalography; Risk Assessment; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Risk Factors; Case-Control Studies; Hypertension; Humans; Female; Posterior Leukoencephalopathy Syndrome; Child; Hypoalbuminemia; Immunosuppressive Agents; Magnetic Resonance Angiography

To investigate the clinical features and prognoses of children who develop reversible posterior encephalopathy syndrome (RPES) during treatment for nephrotic (NS).The clinicoradiological characteristics 51 patients with NS, including 21 RPES 30 without, were analyzed.Compared controls, exhibited a higher rate tacrolimus (P = 0.01) cyclosporine 0.02) treatment; higher-dose prednisolone systolic blood pressure 0.04), serum cholesterol 0.03), proteinuria < 0.01); lower albumin levels 0.03). Hypertension was present in 85.7% patients. The manifestations included an altered mental status, seizures, headaches, nausea vomiting, visual impairment. Electroencephalography findings slow waves focal sharp or/and spiked waves; magnetic resonance imaging showed lesions localized occipital, parietal, frontal, temporal lobes cerebellum brainstem; angiography revealed vertebral artery narrowing. All recovered completely timely appropriate therapy.Hypertension, calcineurin inhibitor high-dose steroid treatments, high levels, low can predispose NS to RPES, although both outcomes are satisfactory.