[Posterior reversible encephalopathy syndrome in children with hematological diseases].

Autor:	Bronina NV; Morozov Children's City Clinical Hospital, Moscow, Russia., Shchederkina IO; Morozov Children's City Clinical Hospital, Moscow, Russia.; Moscow Research and Clinical Centre for Neuropsychiatry, Moscow, Russia., Polushin AY; Pavlov First State Medical University, St. Petersburg, Russia., Seliverstova EV; Morozov Children's City Clinical Hospital, Moscow, Russia., Skiba YB; Pavlov First State Medical University, St. Petersburg, Russia., Kirgizov KI; Blokhin National Medical Research Center of Oncology, Moscow, Russia., Bronin GO; Morozov Children's City Clinical Hospital, Moscow, Russia., Voznyuk IA; Pavlov First State Medical University, St. Petersburg, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2023; Vol. 123 (9. Vyp. 2), pp. 33-42.
DOI:	10.17116/jnevro202312309233
Abstrakt:	Objective: To assess risk factors (RF) and severity grade of Posterior reversible encephalopathy syndrome (PRES) in children with hematological diseases. Material and Methods: We analyzed cases of PRES in children during chemotherapy (CT) and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We estimated the following RF: arterial hypertension, steroid therapy, CT, immunosuppressive therapy (IST), infection and renal injury. Results: Thirty-five cases of PRES occurred in 32 patients (8 after allo-HSCT and 27 during CT) were included in this study. In the most of cases (94.3%), there were 2 and more RF. An increase in blood pressure level (88.6%), CT and IST (82.8%) administration, steroid therapy (71.4%) were the most significant for PRES development. Infectious process and the decline in renal function played a lesser role in this syndrome (31.4% and 14%). At the initial presentation of PRES, there were seizures (94.3%), a decrease of consciousness (28.6%), headache, vision disturbances and stomachache (20%). In the most of cases (91.4%), the 2 nd and 3d grade according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0) were observed. Brain magnetic resonance imaging (MRI) revealed the vasogenic edema of temporal (88.6%), occipital (74.3%), frontal (40%) lobes and the cerebellum (22.9%) more often than the cytotoxic edema ( p =0.03). The cytotoxic edema was observed in the thalamus and the basal ganglia (2.9%) more often than in other parts of the brain ( p <0.01). Conclusion: The majority of PRES cases are caused by more than two RF. Arterial hypertension does not have a leading role among its causes. There is a significant correlation between the grade of PRES according to CTCAE 5.0 score and RF number ( p <0.05).
Databáze:	MEDLINE
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