Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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A Case of Posterior Reversible Encephalopathy Syndrome during Cyclosporine Therapy in a Child with Steroid Resistant Nephrotic Syndrome

스테로이드 저항성 신증후군 환아에서 사이클로스포린 투여 중 발생한 후두엽 가역성 뇌병증 증후군 1례

  • Jeong, Min-Hee (Department of pediatrics, Asan Medical Center, College of Medicine University of Ulsan) ;
  • Lee, Joo-Hoon (Department of pediatrics, Asan Medical Center, College of Medicine University of Ulsan) ;
  • Yum, Mi-Sun (Department of pediatrics, Asan Medical Center, College of Medicine University of Ulsan) ;
  • Ko, Tae-Sung (Department of pediatrics, Asan Medical Center, College of Medicine University of Ulsan) ;
  • Park, Young-Seo (Department of pediatrics, Asan Medical Center, College of Medicine University of Ulsan)
  • 정민희 (울산대학교 의과대학 아산병원 소아과) ;
  • 이주훈 (울산대학교 의과대학 아산병원 소아과) ;
  • 염미선 (울산대학교 의과대학 아산병원 소아과) ;
  • 고태성 (울산대학교 의과대학 아산병원 소아과) ;
  • 박영서 (울산대학교 의과대학 아산병원 소아과)
  • Published : 2007.04.30
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Abstract

The posterior reversible encephalopathy syndrome(PRES) is characterized clinically by a combination of acute or subacute confusion, lethargy, visual disturbance, and seizures. PRES has been described in various clinical settings, including severe hypertension, chemotherapy, eclampsia, and seizure. We report a case of a 7-year-old girl who had taken cyclosporine for steroid resistant nephrotic syndrome. Twenty one days after the cyclosporine therapy, she was admitted due to generalized tonic clonic seizure and headache. Her blood pressure was 170/90 mmHg. Magnetic resonance(MR) imaging showed necrotic/cystic lesions involving the bilateral parieto-occipital region. After discontinuation of cyclosporine, and control of blood pressure, she had no more seizure and headache. The follow-up MR examination which was performed 6 months later showed the decreased extent of the lesion.

후두엽 가역성 뇌병증 증후군은 고혈압, 자간증, 신부전으로 인한 고혈압 및 면역억제약물 등 의 병력과 함께 두통, 구토, 경련, 시야장애 등 임상적 증상을 보이고 뇌 자기공명영상에서 특징적인 소견을 보이는 질환군이다. 저자들은 스테로이드 저항성 신증후군 환아에서 사이클로스포린 투여 중 발생한 후두엽 가역성 뇌병증 증후군을 경험하였기에 보고하는 바이다.

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