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Recurrent posterior reversible encephalopathy syndrome in a patient with focal segmental glomerulosclerosis: A case report

摘要


Introduction: Posterior reversible encephalopathy syndrome (PRES) is a rare clinical syndrome of which the aetiology and pathogenesis still remain unknown. We present a rare case of recurrent PRES in a patient with adult onset nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS). Case Report: A 30-year-old Asian female with FSGS on renal biopsy developed two episodes of PRES with residual neurological deficits without significant hypertension. Both these episodes were preceded by initiation of treatment with calcineurin inhibitors for persistent proteinuria. She was subsequently started on mycophenolate mofetil without further recurrences of PRES. Conclusion: Although PRES is well recognized, this case has a combination of several unusual features that merit special attention. Recurrent PRES, and its association with focal segmental glomerulosclerosis, are extremely rare. Furthermore, development of PRES without significant hypertension and persistent neurological sequelae are rare findings. The association between FSGS and PRES has been previously noted but to our knowledge this is the first case of recurrent PRES in a patient with FSGS.

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