关键词: convulsive seizures kidney transplant recipient posterior reversible encephalopathy syndrome (pres) severe hypertension tacrolimus toxicity

来  源:   DOI:10.7759/cureus.55584   PDF(Pubmed)

Abstract:
Patients with end-stage renal disease (ESRD) who undergo kidney transplantation are at an increased risk of developing surgical and/or medical complications. Posterior reversible encephalopathy syndrome (PRES) is a rare complication that occurs in 0.34% of kidney transplant patients. It is characterized by a combination of neurological manifestations, risk factors, and characteristic radiological findings in neuroimaging studies. The development of PRES has been associated with various medical conditions and factors, including hypertension, the use of cytotoxic and immunosuppressive drugs, acute or chronic kidney disease, pre-eclampsia/eclampsia, autoimmune diseases, and solid organ and bone marrow transplantation. This report presents the case of a 19-year-old woman diagnosed with ESRD on hemodialysis due to lupus nephritis who experienced an episode of PRES with intraparenchymal hemorrhage during the postoperative period of kidney transplantation. The case emphasizes the importance of closely monitoring these patients during this period to enable early diagnosis and timely treatment of complications, ensuring a favorable prognosis.
摘要:
接受肾移植的终末期肾病(ESRD)患者发生手术和/或内科并发症的风险增加。后部可逆性脑病综合征(PRES)是一种罕见的并发症,发生在0.34%的肾移植患者中。它的特点是神经系统表现的组合,危险因素,以及神经影像学研究中的特征性放射学发现。PRES的发展与各种医疗状况和因素有关,包括高血压,使用细胞毒性和免疫抑制药物,急性或慢性肾病,先兆子痫/子痫,自身免疫性疾病,实体器官和骨髓移植。本报告介绍了一名19岁女性因狼疮性肾炎在血液透析中被诊断为ESRD的情况,该女性在肾移植术后期间经历了PRES发作并伴有实质内出血。该案例强调在此期间密切监测这些患者的重要性,以便及早诊断和及时治疗并发症,确保良好的预后。
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