1. [Posterior reversible encephalopathy syndrome in children with hematological diseases].
- Author
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Bronina NV, Shchederkina IO, Polushin AY, Seliverstova EV, Skiba YB, Kirgizov KI, Bronin GO, and Voznyuk IA
- Subjects
- Humans, Child, Magnetic Resonance Imaging methods, Edema complications, Steroids, Posterior Leukoencephalopathy Syndrome diagnostic imaging, Posterior Leukoencephalopathy Syndrome etiology, Hypertension complications, Hematologic Diseases complications
- Abstract
Objective: To assess risk factors (RF) and severity grade of Posterior reversible encephalopathy syndrome (PRES) in children with hematological diseases., Material and Methods: We analyzed cases of PRES in children during chemotherapy (CT) and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We estimated the following RF: arterial hypertension, steroid therapy, CT, immunosuppressive therapy (IST), infection and renal injury., Results: Thirty-five cases of PRES occurred in 32 patients (8 after allo-HSCT and 27 during CT) were included in this study. In the most of cases (94.3%), there were 2 and more RF. An increase in blood pressure level (88.6%), CT and IST (82.8%) administration, steroid therapy (71.4%) were the most significant for PRES development. Infectious process and the decline in renal function played a lesser role in this syndrome (31.4% and 14%). At the initial presentation of PRES, there were seizures (94.3%), a decrease of consciousness (28.6%), headache, vision disturbances and stomachache (20%). In the most of cases (91.4%), the 2
nd and 3d grade according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0) were observed. Brain magnetic resonance imaging (MRI) revealed the vasogenic edema of temporal (88.6%), occipital (74.3%), frontal (40%) lobes and the cerebellum (22.9%) more often than the cytotoxic edema ( p =0.03). The cytotoxic edema was observed in the thalamus and the basal ganglia (2.9%) more often than in other parts of the brain ( p <0.01)., Conclusion: The majority of PRES cases are caused by more than two RF. Arterial hypertension does not have a leading role among its causes. There is a significant correlation between the grade of PRES according to CTCAE 5.0 score and RF number ( p <0.05).- Published
- 2023
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