Posterior Reversible Encephalopathy Syndrome in a Patient with Severe Uremia without Hypertension

作者：Iwafuchi Yoichi^*; Okamoto Kouichirou; Oyama Yuko; Narita Ichiei

来源：Internal Medicine, 2016, 55(1): 63-68.

DOI：10.2169/internalmedicine.55.5563

• posterior reversible encephalopathy syndrome
• normotension
• uremic toxins
• brain magnetic resonance imaging
• hemodialysis
• endothelial dysfunction

A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. Brain magnetic resonance imaging showed reversible vasogenic edema in the brainstem and bilateral frontal centrum semiovale. All of his neurological symptoms immediately improved after the introduction of hemodialysis. When a patient with uremia presents with neurological symptoms, posterior reversible encephalopathy syndrome should be considered in the differential diagnosis even if high blood pressure is not observed. Brain magnetic resonance imaging may be helpful in such a case, and an appropriate therapy could be subsequently initiated.

• 出版日期2016