Background

To demonstrate and compare the clinical manifestations, laboratory findings, and neuroimaging findings of posterior reversible encephalopathy syndrome (PRES) in children with and without underlying renal disease.

Methods

The study included 23 children with a diagnosis of PRES from January 2009 to March 2019. All data, including clinical manifestations, laboratory findings, underlying medical illness, and neuroimaging results, were obtained.

Results

Sixteen had underlying renal disease. The median age of PRES onset was 10.3 years in children with renal disease and 9.8 years in children without renal disease. Higher blood pressure at the baseline, on admission, and at the onset of PRES was found in the renal disease group more than in the nonrenal disease group (P < 0.05). Seizures were likely seen in the renal disease group compared with the nonrenal disease group (P = 0.03). Generalized tonic-clonic seizures were the most common seizure type in both groups. An initial CT scan revealed vasogenic edema in 75% of the renal group and 85.7% of the nonrenal group. During a long-term follow-up, all children recovered without significant neurological deficits or subsequent epilepsy.

Conclusions

Hypertension and higher baseline blood pressure are more common in children with renal disease who develop PRES compared with nonrenal disease. Seizures are more common in the renal disease group. A computed tomographic (CT) scan can help with PRES diagnosis when magnetic resonance imaging is not available. All children with PRES recovered without significant neurological deficits or subsequent epilepsy.

中文翻译：

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患有和不患有肾脏疾病的儿童患有后部可逆性脑病综合征 (PRES) 的临床表现、实验室、神经影像学检查结果和结果的比较

背景

证明和比较有和没有潜在肾脏疾病的儿童后部可逆性脑病综合征 (PRES) 的临床表现、实验室检查结果和神经影像学检查结果。

方法

该研究纳入了 23 名 2009 年 1 月至 2019 年 3 月诊断为 PRES 的儿童。获得了所有数据，包括临床表现、实验室检查结果、基础疾病和神经影像学结果。

结果

16 人患有潜在的肾脏疾病。PRES 发病的中位年龄在患有肾病的儿童中为 10.3 岁，在没有肾病的儿童中为 9.8 岁。肾病组基线、入院时和 PRES 发作时的血压高于非肾病组（P  < 0.05）。与非肾病组相比，肾病组可能出现癫痫发作（P =  0.03）。全身强直阵挛发作是两组中最常见的发作类型。最初的 CT 扫描显示 75% 的肾脏组和 85.7% 的非肾脏组存在血管源性水肿。在长期随访期间，所有儿童都康复了，没有明显的神经功能缺损或随后的癫痫发作。

结论

与非肾病相比，发生 PRES 的肾病儿童更容易出现高血压和较高的基线血压。癫痫发作在肾病组中更为常见。当磁共振成像不可用时，计算机断层扫描 (CT) 扫描有助于 PRES 诊断。所有患有 PRES 的儿童都康复了，没有明显的神经功能缺损或随后的癫痫。