Patterns, risk factors and outcome predictors of posterior reversible encephalopathy syndrome in pediatric cancer patients

Abstract The purpose of this study was to assess the clinical and radiological patterns and outcome predictors of posterior reversible encephalopathy syndrome (PRES) in pediatric cancer patients. A retrospective study included patients who developed PRES during their treatment at the Children's Cancer Hospital Egypt. A total of 50 patients developed PRES. Leukemia and lymphoma were the commonest diagnoses (64%). Regarding the MRI findings, occipital affection was the most common (92%), followed by frontal and temporal lobes involvement in 32% and 22% respectively and advanced PRES was described in 8 patients. Of the whole patients, 80% had complete clinical resolution and 60% showed complete radiological resolution at 2 weeks’ evaluation and 2 patients died out of PRES. Unfavorable outcome was associated with those who had motor dysfunction, status epilepticus at presentation, frontal lobe and thalamic affection and atypical PRES. PRES might present in atypical sites with poor outcome including death.

[1]  D. Super,et al.  Epidemiology, Comorbidities, and Outcomes of Posterior Reversible Encephalopathy Syndrome in Children in the United States. , 2020, Pediatric neurology.

[2]  S. Tetsuka,et al.  Posterior reversible encephalopathy syndrome: A review with emphasis on neuroimaging characteristics , 2019, Journal of the Neurological Sciences.

[3]  N. Özdemir,et al.  Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: Experience of a single center using BFM protocols , 2019, Pediatric blood & cancer.

[4]  Sandeep Jain,et al.  Incidence and Risk Factors for Hypertension During Childhood Acute Lymphoblastic Leukemia Therapy , 2018, Indian Pediatrics.

[5]  D. Zama,et al.  A survey on hematology‐oncology pediatric AIEOP centres: The challenge of posterior reversible encephalopathy syndrome , 2018, European journal of haematology.

[6]  J. Lyo,et al.  Corticosteroid therapy and severity of vasogenic edema in posterior reversible encephalopathy syndrome , 2017, Journal of the Neurological Sciences.

[7]  S. Baleato-González,et al.  Cortical blindness secondary to posterior reversible encephalopathy syndrome, recovered by successful blood pressure management. , 2017, Arquivos brasileiros de oftalmologia.

[8]  J. Lyo,et al.  Imaging characteristics associated with clinical outcomes in posterior reversible encephalopathy syndrome , 2017, Neuroradiology.

[9]  S. Raina,et al.  Predictors of poor outcome in patients with posterior reversible encephalopathy syndrome , 2017, The International journal of neuroscience.

[10]  W. van Paesschen,et al.  Clinical predictors and differential diagnosis of posterior reversible encephalopathy syndrome , 2017, Acta Neurologica Belgica.

[11]  M. Endres,et al.  Factors associated with fatal outcome in posterior reversible encephalopathy syndrome: a retrospective analysis of the Berlin PRES study , 2017, Journal of Neurology.

[12]  E. Schmutzhard,et al.  Posterior reversible encephalopathy syndrome , 2017, Journal of Neurology.

[13]  P. Calabresi,et al.  Prognostic factors in children with PRES and hematologic diseases , 2016, Acta neurologica Scandinavica.

[14]  A. Gajjar,et al.  Imaging Patterns and Outcome of Posterior Reversible Encephalopathy Syndrome During Childhood Cancer Treatment , 2016, Pediatric blood & cancer.

[15]  S. Tummala,et al.  Posterior reversible encephalopathy syndrome in cancer patients: a single institution retrospective study , 2016, Journal of Neuro-Oncology.

[16]  A. Pession,et al.  PRES in Children Undergoing Hematopoietic Stem Cell or Solid Organ Transplantation , 2015, Pediatrics.

[17]  S. Fakhran,et al.  A multi-disciplinary model of risk factors for fatal outcome in posterior reversible encephalopathy syndrome , 2014, Journal of the Neurological Sciences.

[18]  M. Endres,et al.  Posterior reversible encephalopathy syndrome in children: radiological and clinical findings - a retrospective analysis of a German tertiary care center. , 2013, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.

[19]  P. Hantson,et al.  Determinants of Recovery from Severe Posterior Reversible Encephalopathy Syndrome , 2012, PloS one.

[20]  R. Pieters,et al.  Posterior reversible encephalopathy syndrome in childhood cancer. , 2011, Annals of oncology : official journal of the European Society for Medical Oncology.

[21]  D. Kallmes,et al.  Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. , 2010, Mayo Clinic proceedings.

[22]  M. Roncarolo,et al.  High incidence of severe cyclosporine neurotoxicity in children affected by haemoglobinopaties undergoing myeloablative haematopoietic stem cell transplantation: early diagnosis and prompt intervention ameliorates neurological outcome , 2010, Italian Journal of Pediatrics.

[23]  G. Lucchini,et al.  Encephalopathy syndrome in children with hemato‐oncological disorders is not always posterior and reversible , 2008, Pediatric blood & cancer.

[24]  P. Uvebrant,et al.  Studies of cerebral blood flow in children with acute lymphoblastic leukemia: case reports of six children treated with methotrexate examined by single photon emission computed tomography. , 1997, Journal of pediatric hematology/oncology.

[25]  N. Perico,et al.  THE ACUTE EFFECT OF FK506 AND CYCLOSPORINE ON ENDOTHELIAL CELL FUNCTION AND RENAL VASCULAR RESISTANCE , 1992, Transplantation.