Pediatric posterior reversible encephalopathy syndrome: Age related clinico-radiological profile and neurologic outcomes.

Autor: Ekinci F; Department of Pediatric Intensive Care, Cukurova University Faculty of Medicine, Adana, Turkey., Yildizdas D; Department of Pediatric Intensive Care, Cukurova University Faculty of Medicine, Adana, Turkey., Horoz OO; Department of Pediatric Intensive Care, Cukurova University Faculty of Medicine, Adana, Turkey., Gul Mert G; Department of Pediatric Neurology, Cukurova University Faculty of Medicine, Adana, Turkey., Kaya O; Department of Radiology, Cukurova University Faculty of Medicine, Adana, Turkey., Bayram I; Department of Pediatric Oncology, Cukurova University Faculty of Medicine, Adana, Turkey., Atmis B; Department of Pediatric Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey., Leblebisatan G; Department of Pediatric Hematology, Cukurova University Faculty of Medicine, Adana, Turkey., Sezgin G; Department of Pediatric Oncology, Cukurova University Faculty of Medicine, Adana, Turkey., Yavas DP; Department of Pediatric Intensive Care, Cukurova University Faculty of Medicine, Adana, Turkey.
Jazyk: angličtina
Zdroj: Pediatrics international : official journal of the Japan Pediatric Society [Pediatr Int] 2023 Jan-Dec; Vol. 65 (1), pp. e15562.
DOI: 10.1111/ped.15562
Abstrakt: Background: The aim of this study was to analyze the characteristics of pediatric posterior reversible encephalopathy syndrome (PRES) to determine clinical and radiologic differences between younger and older age groups, and to identify risk factors for development of any neurologic sequelae.
Methods: The study cohort consisted of confirmed pediatric PRES patients in a tertiary care university hospital from January, 2015, to December, 2020. Demographic and clinical properties, radiological manifestations, and neurologic outcomes were noted. Children aged ≤6 years were compared with those older than 6 years and factors affecting neurologic outcomes were evaluated.
Results: The most common underlying diseases were oncological (37%) and kidney diseases (29%). Epileptic seizures were the most frequent symptoms at initial clinical presentation. The regions in the brain that were most commonly involved were the occipital region (n = 65, 96%), the parietal region (n = 52, 77%), and the frontal lobe (n = 35, 54%). Magnetic resonance imaging (MRI) findings were consistent with atypical patterns in most of the study cohort (71%). Patients with unfavorable clinical outcomes (n = 13, 19.1%) had longer initial seizure times and longer encephalopathy times, lower leucocyte and absolute neutrophil counts, and lower neutrophil to lymphocyte ratios. No relationship was found between MRI findings, involvement patterns, and neurologic outcomes.
Conclusions: No clinically specific differences between two different age groups were found. Atypical imaging manifestations of pediatric PRES in our study had an incidence that was as high as those found in earlier adult studies. Multivariate logistic regression analysis showed that the initial neutrophil to lymphocyte ratio, absolute neutrophil counts, and white cell counts could not predict poor neurologic outcomes.
(© 2023 Japan Pediatric Society.)
Databáze: MEDLINE
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