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Acute glomerulonephritis presenting with PRES: a report of 4 cases
E C Wirrell1, L D Hamiwka, L A Hamiwka
1Division of Pediatric Neurology, Department of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Summary
Posterior reversible encephalopathy syndrome (PRES) can affect children presenting with neurological symptoms. Prompt blood pressure measurement and hypertension treatment are crucial for recovery.
Area of Science:
- Pediatric Neurology
- Nephrology
- Radiology
Background:
- Posterior reversible encephalopathy syndrome (PRES) is often associated with hypertension or immunosuppression.
- PRES typically presents with neurological symptoms like seizures and altered mentation.
Observation:
- Four previously healthy children presented with acute neurological symptoms including altered mentation, seizures, and visual disturbances.
- Hypertension was discovered only after the onset of neurological symptoms in all four children.
- Glomerulonephritis was diagnosed in all four cases.
Findings:
- All patients experienced rapid resolution of neurological symptoms following effective hypertension management.
- Only one child had a history of gross hematuria preceding the seizure.
Implications:
- Prompt blood pressure measurement is essential for children with PRES-like symptoms.
- Elevated blood pressure in this context warrants strong consideration of PRES and renal disease workup.
- Early diagnosis and management of hypertension are key to favorable neurological outcomes in pediatric PRES.
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