Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Posterior reversible encephalopathy syndrome (PRES) is a relatively new clinical entity characterized by reversible neurological symptoms with findings indicating leukoencephalopathy on imaging studies. Reports of PRES in the field of anesthesiology have been quite limited. A patient with therapeutic anticoagulant developed PRES immediately after emergence from anesthesia, in which her status was initially recognized as delayed recovery from anesthesia with transient hypertension because an emergent head computed tomography (CT) scan was almost normal. Subsequently, magnetic resonance imaging (MRI) was also performed according to a radiologist's recommendation because the CT results showed areas of slightly low attenuation in the frontoparieto-occipital lobes bilaterally, suggesting PRES; otherwise, ischemic events. MRI showed subcortical increased T(2) and fluid-attenuated inversion recovery (FLAIR) intensity in the occipitoparietal regions bilaterally with slight increase in the apparent diffusion coefficient signal on diffusion-weighted imaging, which confirmed a diagnosis of PRES. Gradually, the patient regained consciousness and became responsive with antihypertensive therapy. A prompt and accurate diagnosis of PRES is important to avoid irreversible brain damage, for example, intracranial hemorrhage, especially in a patient receiving anticoagulation therapy.
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PMID:A case of posterior reversible encephalopathy syndrome after emergence from anesthesia. 2201 72

Takayasu's arteritis is a chronic, idiopathic, inflammatory disease primarily affecting aorta and its branches. It mainly affects young females in the age group of 10-30 years. Various atypical presentations of Takayasu's arteritis have been described in children. These atypical presentations can cause delayed diagnosis resulting in increased morbidity and mortality. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic condition associated with headache, seizures, altered sensorium, visual disturbances, and characteristic lesions on neuroimaging. We report a child with Takayasu's arteritis who presented a posterior reversible encephalopathy syndrome. He also had associated abdominal tuberculosis for which anti-tuberculous treatment was started. PRES was diagnosed by magnetic resonance imaging with fluid-attenuated inversion recovery sequences. The child was started on nifedipine and propranolol. The child regained his consciousness within 48 h of admission. Prompt treatment of hypertension led to rapid reversal of neurological symptoms. In view of hypertension a computed tomography aortogram was done, which showed features suggestive of high grade (>75%) focal proximal left renal artery stenosis. EULAR (European League Against Rheumatism)/PReS (Paediatric Rheumatology European Society) consensus criteria was used for the diagnosis of Takayasu's arteritis in our patient. Percutaneous transluminal balloon angioplasty of the stenotic left renal artery was performed. Post-angioplasty, nifedipine was gradually omitted and oral propranolol was continued.
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PMID:Unusual presentation of Takayasu's arteritis as posterior reversible encephalopathy syndrome. 2202 40

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity that may occur in patients receiving anti-vascular endothelial growth factor (VEGF) agents such as bevacizumab and tyrosine kinase inhibitors. Little is known about the characteristics of patients at risk for PRES under anti-VEGF agents. We carried out a comprehensive review of reports documenting the occurrence of PRES in patients receiving anti-VEGF agents. Twenty-six patients are described with a majority of females (73.1%). Almost a third of patients had a past history of hypertension. The most common symptoms included headache, visual disturbance and seizure. A vast majority of patients had hypertension at the diagnosis of PRES, and proteinuria was detectable each time it was investigated. Neurological outcome was favorable in all cases with a symptomatic treatment including blood pressure control. The risk of PRES is increased when blood pressure is poorly controlled and when proteinuria is detectable. The clinical course appears favorable with a symptomatic treatment. PRES is a potentially severe but manageable toxicity of anti-VEGF agents.
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PMID:Posterior reversible encephalopathy syndrome induced by anti-VEGF agents. 2209 Feb 60

Posterior reversible encephalopathy syndrome (PRES) has been reported in childhood leukemia patients increasingly frequently. However, the development of PRES in adult leukemia patients during chemotherapy is very rare. We present a case of PRES in an adult patient with acute lymphoblastic leukemia (ALL) after remission induction chemotherapy. A 28-year-old woman with ALL was administered remission induction chemotherapy consisting of cyclophosphamide, daunorubicin, vincristine, prednisone, and L-asparaginase. After initiation of chemotherapy, the patient developed paralytic ileus and hypertension, and on day 30, she suddenly developed generalized convulsions, loss of visual acuity, and muscle weakness in the legs. Magnetic resonance imaging findings and her signs and symptoms were typical of PRES. The symptoms gradually improved following treatment with an anticonvulsant and an antihypertensive agent, and the patient underwent allogeneic bone marrow transplantation. She has completely recovered from PRES and has been asymptomatic without leukemia relapse. During remission induction chemotherapy for ALL, PRES may be caused by multiple drugs, such as L-asparaginase, vincristine, and corticosteroids, with different mechanisms of action. PRES should be recognized as an important complication, which will occur more frequently with the increased intensity of chemotherapy for adult ALL patients.
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PMID:Posterior reversible encephalopathy syndrome in an adult patient with acute lymphoblastic leukemia after remission induction chemotherapy. 2216 Aug 36

Posterior reversible encephalopathy syndrome (PRES) is a rare but if diagnosed late an irreversible disease. The majority of the patients present with severe hypertension, and effective blood pressure control is the mainstay of therapy. In this case report, we present three cases with PRES, treated successfully with strict volume control policy and propose that strict volume control policy may be a key element for the treatment of PRES.
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PMID:Can strict volume control be the key for treatment and prevention of posterior reversible encephalopathy syndrome in hemodialysis patients? 2236 Apr 71

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of encephalopathy, headache, visual disturbance, and seizures. In most cases, symptoms present acutely or subacutely in the setting of accelerated hypertension, eclampsia, autoimmune disease, immunosuppressive treatment, or cancer chemotherapy. One essential feature of PRES is the presence of reversible cerebral vasogenic edema that has a predominantly posterior distribution on brain imaging. Atypical imaging features are commonly described, including involvement of the anterior brain or brainstem and the coexistence of ischemia or hemorrhage. In most cases, both clinical and radiological findings are reversible, although permanent imaging abnormalities and residual neurological sequelae can be seen in a minority of patients. The syndrome is thought to be caused by a breakdown of the blood-brain barrier and an extravasation of the intravascular fluid. Treatment of hypertension and seizures, and withdrawal of causative agents are the mainstays of therapy in PRES.
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PMID:Posterior reversible encephalopathy syndrome: clinicoradiological spectrum and therapeutic strategies. 2240 96

Posterior reversible encephalopathy syndrome is a clinico-neuroradiologic entity with typical symptoms and symmetric high-signal intensity lesions in the bilateral parietooccipital lobes on T2-weighted or fluid-attenuated inversion recovery magnetic resonance imaging. In this presentation, we report a case of posterior reversible encephalopathy syndrome who was admitted to our emergency department because of seizure and deterioration of consciousness. The aim of this presentation is to alert the emergency physicians about one of the hypertensive emergencies with neurologic symptoms associated with hypertension.
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PMID:A rare entity in ED: posterior reversible encephalopathy syndrome. 2256 Jan

Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuro-radiological entity may develop in patients with pre-eclampsia, eclampsia or delayed postpartum eclampsia, immunological conditions and with certain anti-neoplastic agents. This case report describes about a patient with pregnancy induced hypertension who developed PRES postnatally. Early recognition and treatment prevented serious morbidity.
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PMID:Posterior reversible encephalopathy syndrome. 2367 43

Posterior reversible encephalopathy syndrome is characterized by varying neurologic symptoms associated with brain vasogenic edema. Posterior reversible encephalopathy syndrome can be associated with severe hypertension (eg, in eclampsia or HELLP syndrome), but it also has been observed without hypertension and in several clinical conditions including infections and autoimmune disorders. The literature offers several reports of posterior reversible encephalopathy syndrome detected or induced after bone-marrow and solid-organ transplant, or induction by immunosuppression. We describe what is, to the best of our knowledge, the first case of man who successfully underwent a kidney transplant with preexisting posterior reversible encephalopathy syndrome induced by Goodpasture's syndrome.
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PMID:Kidney transplant after preexisting posterior reversible encephalopathy syndrome induced by Goodpasture's syndrome. 2263 Oct 71

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity. It associates, to varying extents, neurological symptoms such as headaches, confusion, seizures and visual alterations from haemianopsia to cortical blindness. The diagnosis relies on brain MRI, showing signs of subcortical and cortical oedema in the posterior regions of the brain, with hypersignals in T2/fluid attenuated inversion recovery (FLAIR) or diffusion sequences. With early diagnosis and control of the causal factors, the symptoms and radiological signs can be - as the name implies - totally regressive. PRES can be caused by various heterogeneous factors, such as hypertension, side effect of drug therapies, eclampsia, sepsis or autoimmune diseases. The authors report here the case of an 86-year-old woman, presenting totally regressive cortical blindness and seizures, with compatible imaging.
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PMID:Cortical blindness and posterior reversible encephalopathy syndrome in an older patient. 2266 15


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