Korean J Nephrol.  2001 Jan;20(1):143-146.

A Case of Reversible Posterior Leukoencepalopathy Syndrome during Steroid Therapy in a Down Syndrome with Nephrotic Syndrome

• Lee JE
• Kim BS
• Lee HI
• Choi MS
• Chung SW
• Lee SH
• Choi EJ
• Bang BK

Abstract

The reversible posterior leukoencephalopathy syndrome usually includes seizure, headache, altered mental status, and blindness, often associated with hypertension and immunosuppressants. The authors discuss a 16-year-old female with Down syndrome who had nephrotic syndrome with severe headache, intermittent blindness, and seizures, after treated with prednisolone. The patient had a generalized tonic-clonic seizure at 8 days after prednisolone. A CT scan of the head revealed symmetrical multifocal low densities in the subcortical region of both parieto-occipital, frontal, temporal lobe. Magnetic resonance scanning revealed white matter lesions in the subcortices of the parietal, frontal and occipital lobes. The condition improved when prednisolone was discontinued. Follow-up image after 3 weeks shows nearly complete resolution of white matter and gray matter abnormalities on axial T2-weighted MR images. This episode might be caused by prednisolone because the clinical course and laboratory data revealed neither inflammation nor other causative factors.

Keyword

Reversible posterior, leukoencepalopathy syndrome; Nephrotic syndrome; Steroid

MeSH Terms

Adolescent
Blindness
Down Syndrome*
Female
Follow-Up Studies
Head
Headache
Humans
Hypertension
Immunosuppressive Agents
Inflammation
Nephrotic Syndrome*
Occipital Lobe
Posterior Leukoencephalopathy Syndrome
Prednisolone
Rabeprazole
Seizures
Temporal Lobe
Tomography, X-Ray Computed
Immunosuppressive Agents
Prednisolone