Recurrent and atypical posterior reversible encephalopathy syndrome in a child with peritoneal dialysis

Area of Science:

• Neurology
• Nephrology
• Radiology

Background:

• Posterior reversible encephalopathy syndrome (PRES) is a neurological condition with characteristic symptoms and imaging findings.
• PRES typically affects the parietooccipital lobes but can present with atypical localizations.
• Hypertension and renal failure are common causes of PRES.

Observation:

• This case report details recurrent atypical PRES in a child with end-stage renal disease undergoing peritoneal dialysis.
• The patient experienced PRES recurrence attributed to infections and sudden blood pressure increases.
• Atypical PRES localization was noted in this pediatric patient.

Findings:

• Recurrent PRES, particularly atypical forms, can occur in pediatric patients with end-stage renal disease.
• Infections and hypertensive surges were identified as triggers for PRES recurrence.
• The case highlights the potential for PRES to manifest beyond typical locations.

Implications:

• Early diagnosis and prompt intervention are vital for the successful treatment and reversibility of PRES.
• PRES should be considered in the differential diagnosis for seizures or coma in patients with chronic kidney disease.
• This case underscores the importance of vigilant monitoring and management in pediatric patients with renal disease and neurological symptoms.