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Posterior reversible encephalopathy syndrome in childhood with hematologic/oncologic diseases

Sung Chul Won1, Seung Yeon Kwon, Jung Woo Han

  • 1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea.

Journal of Pediatric Hematology/Oncology
|July 1, 2009
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) is a rare neurological complication in pediatric cancer patients. This study suggests chemotherapy and surgery may also contribute to PRES, alongside immunosuppressive agents.

Area of Science:

  • Neurology
  • Pediatric Oncology
  • Radiology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by specific MRI findings and clinical symptoms.
  • It is a rare central nervous system complication in childhood hematologic-oncologic patients, with varied neurological presentations.
  • The exact causes of PRES are not fully understood.

Purpose of the Study:

  • To review cases of PRES in pediatric patients with hematologic-oncologic conditions.
  • To identify potential contributing factors to PRES beyond known causes.
  • To highlight the importance of recognizing this complication for timely management.

Main Methods:

  • Retrospective review of 8 pediatric patients diagnosed with PRES.
  • Analysis of patient diagnoses, treatments (chemotherapy, immunosuppressants, stem cell transplantation), and surgical history.
  • Correlation of clinical symptoms and characteristic MRI findings.

Main Results:

  • The study included patients with acute lymphocytic leukemia, aplastic anemia, and solid tumors.
  • All patients experienced seizures and presented with typical PRES MRI findings.
  • Follow-up MRIs showed significant improvement in all patients.

Conclusions:

  • Chemotherapy and surgery may be additional contributing factors to PRES in pediatric oncology patients, besides immunosuppressive agents.
  • Close monitoring of patients undergoing chemotherapy and surgery is crucial for early detection of PRES.
  • PRES, though uncommon, appears to have a good prognosis with appropriate management.

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