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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Immunosuppressive Drugs, an Emerging Cause of Posterior Reversible Encephalopathy Syndrome: Case Series
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Immunosuppressive Drugs, an Emerging Cause of Posterior Reversible Encephalopathy Syndrome: Case Series

机译：免疫抑制药物，后可逆性脑病综合征的新兴原因：病例系列

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Background: Posterior reversible encephalopathy syndrome (PRES) is a well-recognized complication of hypertensive encephalopathy. Recently, pre-eclampsia, connective tissue disorders, and immunosuppressive drugs have been reported to be the etiologies of this rare syndrome. Methods: We evaluated 9 cases of PRES whose diagnosis were confirmed based on clinical and radiologic evidence between July 2011 and December 2013 in a tertiary center, Imam Khomeini Hospital, Tehran, Iran. Results: Immunosuppressive drugs, especially cyclosporine, and hypertension were the main precipitating factors. In this study, seizure was the most common clinical presentation (100%), whereas other common clinical presentations were confusion (78%), visual loss (67%), and headaches (67%). With conservative management and elimination of predisposing factor, the patients improved gradually except for 2 cases who experienced prolonged recovery period because of delayed diagnosis. Conclusions: With timely diagnosis, PRES generally has a good prognosis with complete recovery. However, in missed conditions, it could be associated with catastrophic burden especially in organ transplantation after a prolonged time spending to find matched donors or in chronic immunosuppressive conditions. Thereupon, physicians should be aware of clinical and radiologic manifestations of this preventable but potentially disabling syndrome.
机译：背景：后可逆性脑病综合征（PRES）是高血压脑病的一种公认的并发症。最近，据报道先兆子痫，结缔组织疾病和免疫抑制药物是这种罕见综合征的病因。方法：我们评估了2011年7月至2013年12月在伊朗德黑兰伊玛目霍梅尼医院的三级中心根据临床和放射学证据确诊的9例PRES。结果：免疫抑制药物，尤其是环孢霉素和高血压是主要诱发因素。在这项研究中，癫痫发作是最常见的临床表现（100％），而其他常见的临床表现是精神错乱（78％），视力减退（67％）和头痛（67％）。通过保守治疗和消除诱发因素，除2例因诊断延迟而恢复时间延长的患者外，患者逐渐好转。结论：通过及时诊断，PRES通常预后良好，完全康复。然而，在遗漏的情况下，这可能与灾难性的负担相关，尤其是在花费较长时间寻找匹配的供体后的器官移植中或在慢性免疫抑制的情况下。因此，医生应意识到这种可预防但可能致残的综合症的临床和影像学表现。

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