Posterior Reversible Encephalopathy Syndrome in Patients with Coronavirus Disease 2019: Two Cases and A Review of The Literature
| Autor: | Anna M. Cervantes-Arslanian, Deepti Virmani, Pria Anand, Asim Mian, Courtney Takahashi, K. H. Vincent Lau, David Y. Chung |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Pediatrics medicine.medical_specialty medicine.medical_treatment Pneumonia Viral Encephalopathy Clinical Neurology Blood Pressure HIV Infections medicine.disease_cause Article PRES Betacoronavirus 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Risk Factors Humans Medicine Pandemics Coronavirus Anakinra Coinfection SARS-CoV-2 business.industry Rehabilitation COVID-19 Posterior reversible encephalopathy syndrome Immunosuppression Middle Aged Prognosis medicine.disease chemistry Posterior Leukoencephalopathy Syndrome Host-Pathogen Interactions Female Surgery Endothelium Vascular Neurology (clinical) Coronavirus Infections business Complication Cardiology and Cardiovascular Medicine Immunosuppressive Agents 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases |
| ISSN: | 1532-8511 1052-3057 |
| Popis: | Highlights • Posterior reversible encephalopathy syndrome may be associated with coronavirus disease. • Risk factors may include modest blood pressure fluctuations and anakinra. • All reported patients had clinical improvement. Introduction Encephalopathy is a common complication of coronavirus disease 2019. Although the encephalopathy is idiopathic in many cases, there are several published reports of patients with posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019. Objective To describe the diverse presentations, risk factors, and outcomes of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019. Methods We assessed patients with coronavirus disease 2019 and a diagnosis of posterior reversible encephalopathy syndrome at our institution from April 1 to June 24, 2020. We performed a literature search to capture all known published cases of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019. Results There were 2 cases of posterior reversible encephalopathy syndrome in the setting of coronavirus 2019 at our institution during a 3-month period. One patient was treated with anakinra, an interleukin-1 inhibitor that may disrupt endothelial function. The second patient had an underlying human immunodeficiency virus infection. We found 13 total cases in our literature search, which reported modest blood pressure fluctuations and a range of risk factors for posterior reversible encephalopathy syndrome. One patient was treated with tocilizumab, an interleukin-6 inhibitor that may have effects on endothelial function. All patients had an improvement in their neurological symptoms. Interval imaging, when available, showed radiographic improvement of brain lesions. Conclusions Risk factors for posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019 may include underlying infection or immunomodulatory agents with endothelial effects in conjunction with modest blood pressure fluctuations. We found that the neurological prognosis for posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019 infection is favorable. Recognition of posterior reversible encephalopathy syndrome in this patient population is critical for prognostication and initiation of treatment, which may include cessation of potential offending agents and tight blood pressure control. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect