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Acute Glomerulonephritis Presenting With PRES: A Report of 4 Cases

Published online by Cambridge University Press:  02 December 2014

E C Wirrell ,
L D Hamiwka ,
L A Hamiwka ,
S Grisaru  and
X Wei
E C Wirrell
Affiliation:
The Division of Pediatric Neurology, Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
L D Hamiwka
Affiliation:
The Division of Pediatric Neurology, Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
L A Hamiwka
Affiliation:
Division of Pediatric Nephrology, University of Calgary, Calgary, AB, Canada
S Grisaru
Affiliation:
Division of Pediatric Nephrology, University of Calgary, Calgary, AB, Canada
X Wei
Affiliation:
Department of Pediatrics, Radiology, University of Calgary, Calgary, AB, Canada
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Abstract

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Objective:

Posterior reversible encephalopathy syndrome (PRES) occurs most commonly in the setting of known hypertension or use of immunosuppressive agents.

Design and Methods:

We report four previously-well children who presented acutely with altered mentation, seizures and visual disturbances and were diagnosed with PRES.

Results:

Only one child had a history of gross hematuria prior to the seizure. All four were discovered to be hypertensive only after onset of their neurological symptoms, and were subsequently diagnosed with glomerulonephritis. All four had rapid resolution of neurological symptoms with adequate treatment of hypertension.

Conclusions:

Blood pressure must be measured promptly in all children presenting with these symptoms. If elevated, the diagnosis of PRES should be strongly considered and a workup for renal disease pursued.

Résumé:

RÉSUMÉ:

Qustre observations cliniques de glomérulonéphrite aiguë avec tableau de SERP. Objectif : Le syndrome d'encéphalopathie réversible postérieure (SERP) se rencontre le plus souvent dans le cadre d'une hypertension connue ou de la prise d'immunosuppresseurs. Plan d'étude et méthodes : Nous décrivons quatre enfants en bonne santé qui ont présenté de façon aiguë une détérioration de l'état mental, des convulsions et des troubles visuels, chez qui on a posé un diagnostic de SERP. Résultats : Un seul enfant avait une histoire d'hématurie macroscopique avant les convulsions. On a posé un diagnostic d'hypertension chez tous seulement après le début des symptômes neurologiques et un diagnostic de glomérulonéphrite a été posé par la suite. Les symptômes neurologiques ont disparu rapidement après traitement adéquat de l'hypertension. Conclusions : La pression artérielle doit être mesurée rapidement chez tous les enfants qui présentent ce tableau clinique. Si elle est élevée, il est important de considérer qu'il pourrait s'agir d'un SERP et de procéder à un bilan rénal.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 3 , August 2007 , pp. 316 - 321
Copyright
Copyright © The Canadian Journal of Neurological 2007

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