Henoch-Schonlein purpura nephritis complicated by reversible posterior leukoencephalopathy syndrome

被引:16
作者
Sasayama, Daimei [1 ]
Shimojima, Yasuhiro [1 ]
Gono, Takahisa [1 ]
Kaneko, Kazuma [1 ]
Matsuda, Masayuki [1 ]
Ikeda, Shu-ichi [1 ]
机构
[1] Shinshu Univ, Sch Med, Dept Med 3, Matsumoto, Nagano 390, Japan
关键词
continuous hemodiafiltration; Henoch-Schonlein purpura; hypertension; renal insufficiency; reversible posterior leukoencephalopathy syndrome;
D O I
10.1007/s10067-006-0502-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We report a young female patient with Henoch-Schonlein purpura (HSP) nephritis complicated by reversible posterior leukoencephalopathy syndrome (RPLS). The patient suddenly showed generalized seizures and cortical blindness with severe hypertension due to renal insufficiency approximately 1 year after cessation of corticosteroid treatment for HSP nephritis. Magnetic resonance imaging (MRI) demonstrated bilateral abnormal signals mainly in the cerebellum and white matter of the occipital lobe. Clinical symptoms quickly improved in conjunction with disappearance of abnormal signals on brain MRI after starting control of hypertension and continuous hemodiafiltration with steroid pulse therapy and plasmapheresis. RPLS may be caused by vasculitis and also by hemodynamic change due to severe hypertension in HSP, particularly in patients with nephropathy. In such cases intensive treatment should be performed as soon as possible to avoid neurological sequelae.
引用
收藏
页码:1761 / 1763
页数:3
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