Korean J Nephrol.  2001 Jan;20(1):127-131.

A Case of Reversible Posterior Leukoencephalopathy Syndrome in Patient with Chronic Renal Failure

• Koo YS
• Kim DH
• Chang YK
• Yang JO
• Kang MG
• Hwang PJ
• Song CJ
• Lee KW
• Shin YT

Abstract

A Reversible Posterior Leukoencephalopathy Syndrome(RPLS) consists of neurologic symptoms and signs - headache, consciousness change, seizure, visual impairment - and brain imaging finding showing brain(espicially white matter) edema usually involving the posteior parietal-temporal-occipital areas. The causes are thought to be hypertensive encephalopathy, pre-eclampsia or eclampsia, renal failure with fluid overload and immunosuppressive agents such as cyclosporin A or FK506. RPLS may usually reversible if treated early by decreasing blood pressure and discontinuing offending drugs. A 23-year-old man had been hemodialyzed with chronic renal failure for two years. His blood pressure elevated to 240/150mmHg 3 days before admission and he complained of severe headache, vomiting, and total visual loss at the day of admission. Brain T2-weighted MRI imaging showed increased signal intensity involving the both parietal, posterior temporal, and occipital lobes. After antihypertensive and dexamethason treatment, a follow-up brain MRI performed on 7 days after admission showed nearly normalized findings and all symptoms including visual loss were recovered completely in one week.

Keyword

Posterior leukoencephalopathy syndrome; Blindness; Chronic renal failure

MeSH Terms

Blindness
Blood Pressure
Brain
Consciousness
Cyclosporine
Eclampsia
Edema
Female
Follow-Up Studies
Headache
Humans
Hypertensive Encephalopathy
Immunosuppressive Agents
Kidney Failure, Chronic*
Leukoencephalopathies
Magnetic Resonance Imaging
Neuroimaging
Neurologic Manifestations
Occipital Lobe
Posterior Leukoencephalopathy Syndrome*
Pre-Eclampsia
Pregnancy
Rabeprazole
Renal Insufficiency
Seizures
Tacrolimus
Vomiting
Young Adult
Cyclosporine
Immunosuppressive Agents
Tacrolimus