Posterior reversible encephalopathy syndrome associated with Guillain-Barré syndrome: Case report and clinical management considerations.


Journal

Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 03 09 2019
revised: 03 03 2020
accepted: 27 03 2020
pubmed: 15 4 2020
medline: 9 7 2021
entrez: 15 4 2020
Statut: ppublish

Résumé

Around half of the patients with Guillain-Barré syndrome (GBS) present autonomic dysfunction requiring admission to intensive care unit in up to a quarter of patients. Treatment of GBS consists of plasma exchange (PE) and intravenous immunoglobulins (IVIG). Posterior reversible encephalopathy syndrome (PRES) consists in a reversible subcortical vasogenic brain edema caused by endothelial damage triggered by abrupt blood pressure changes. We report on a woman who presented with PRES in the course of GBS treated first with IVIG, and then with PE. The present report underlines the challenge that the clinicians face when these two rare syndromes concur. The literature is not helpful considering that both blood pressure fluctuations and IVIG are reported to be involved in the pathogenesis of PRES. In the present letter, both pathogenic mechanisms and clinical management considerations are discussed.

Identifiants

pubmed: 32289176
doi: 10.1002/jca.21783
doi:

Substances chimiques

Immunoglobulins, Intravenous 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

231-233

Informations de copyright

© 2020 Wiley Periodicals, Inc.

Références

Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol. 2015;14(9):914-925.
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Stetefeld HR, Lehmann HC, Fink GR, Burghaus L. Posterior reversible encephalopathy syndrome and stroke after intravenous immunoglobulin treatment in Miller-Fisher syndrome/Bickerstaff brain stem encephalitis overlap syndrome. J Stroke Cerebrovasc Dis. 2014;23(9):e423-e425.
Tombak A, Uçar MA, Akdeniz A, et al. Therapeutic plasma exchange in patients with neurologic disorders: review of 63 cases. Indian J Hematol Blood Transfus. 2017;33(1):97-105.
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Colls BM. Guillain-Barré syndrome and hyponatraemia. Intern Med J. 2003;33(1-2):5-9.
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Auteurs

Alessandro Salvalaggio (A)

Department of Neurosciences, University of Padova, Padova, Italy.

Annachiara Cagnin (A)

Department of Neurosciences, University of Padova, Padova, Italy.

Piero Marson (P)

Apheresis Unit, Blood Transfusion Service, University Hospital of Padova, Padova, Italy.

Franco Ferracci (F)

Neurology Unit, "San Martino" Hospital of Belluno, Belluno, Italy.

Pietro Cortelli (P)

IRCCS - Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.

Maurizio Corbetta (M)

Department of Neurosciences, University of Padova, Padova, Italy.

Chiara Briani (C)

Department of Neurosciences, University of Padova, Padova, Italy.

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