Obstet Gynecol Sci.  2019 Jan;62(1):69-72. 10.5468/ogs.2019.62.1.69.

Posterior reversible encephalopathy syndrome in a woman who used gonadotropin-releasing hormone agonists: a case report

• Lee M
• Kim TH
• Kim SJ
• Jee BC

• KMID: 2430932
• DOI: http://doi.org/10.5468/ogs.2019.62.1.69

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a newly described adverse effect possibly associated with gonadotropin-releasing hormone (GnRH) agonist therapy. We report a case of PRES after 2 doses of depot GnRH agonists in a 44-year-old woman with a huge myoma uteri and iron-deficiency anemia. Brain magnetic resonance imaging showed high signal lesions in both occipital lobes on fluid-attenuated inversion-recovery (FLAIR) images, compatible with PRES. After treatment with anticonvulsant, she recovered both radiographically and clinically. The association between PRES and GnRH agonist use is still enigmatic, and thus should be further clarified.

Keyword

Gonadotropin-releasing hormone; Leuprolide; Brain diseases; Myoma

MeSH Terms

Adult
Anemia, Iron-Deficiency
Brain
Brain Diseases
Female
Gonadotropin-Releasing Hormone*
Humans
Leuprolide
Magnetic Resonance Imaging
Myoma
Occipital Lobe
Posterior Leukoencephalopathy Syndrome*
Uterus
Gonadotropin-Releasing Hormone
Leuprolide

Figure

• 

  Fig. 1 Initial brain magnetic resonance imaging shows the abnormal high signal change in both occipital lobe on fluid-attenuated inversion-recovery (FLAIR) image (A, B), left putamen (C), and right cerebellum (D).

• 

  Fig. 2 Follow-up brain magnetic resonance imaging at 4 weeks after the initial visit demonstrates that the original lesions of high signal intensity in both occipital lobe (A, B), left putamen (C), and right cerebellum have disappeared (D).

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