Posterior Reversible Encephalopathy Syndrome in children/ adolescents with hematologic malignancies: Case reports

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Published Mar 30, 2025
https://doi.org/10.62438/tunismed.v103i4.5069
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Vol. 103 No. 4 (2025): Tunis Med Apr 2025

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Rim Aidli
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Marwa Bahri
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Noureddine Louati
Department of radiology, La Rabta Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Hela Sahbani
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Emna Azza
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Yosr Ben Abdennebi
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.
Lamia Aissaoui
Department of pediatric hematology, Aziza Othmana Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar,Tunis,Tunisia.

Abstract

 


Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) is one of the most common neurological complications in pediatric onco-hematology. Hematologic malignancies and cytotoxic chemotherapy are involved in its pathogenesis. It’s a clinical and radiological entity: the diagnosis of PRES is based on both clinical symptoms and neuroimaging data.


Observation: Here we reported a series of four cases of children/ adolescents treated by cytotoxic chemotherapy for hematologic malignancies who developed neurologic disorders and their magnetic resonance imaging findings were in favor of PRES.


Conclusion:In onco-hematology, children/ adolescents who present with new seizures, visual deficits, or other neurologic signs, PRES should be considered as a part of the differential diagnosis as a good outcome relies on rapid management of this complication

Keywords:

case report, chemotherapy, children, hematologic diseases, posterior leukoencephalopathy syndrome

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References

  1. Anastasopoulou S, Eriksson MA, Heyman M, Wang C, Niinimäki R, Mikkel S, et al. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: clinical characteristics, risk factors, course, and outcome of disease. Pediatr Blood Cancer. 2019;66(5):e27594.
  2. Gavrilovici C, Miron I, Voroneanu L, Bădărau S, Stârcea M. Posterior reversible encephalopathy syndrome in children with kidney disease. Int Urol Nephrol. 2017;49(10):1793‑800.
  3. Gaziev J, Marziali S, Paciaroni K, Isgrò A, Di Giuliano F, Rossi G, et al. Posterior reversible encephalopathy syndrome after hematopoietic cell transplantation in children with hemoglobinopathies. Biol Blood Marrow Transplant. 2017;23(9):1531‑40.
  4. Hinchey J, Pao L, Mas JL. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334(8).
  5. Parasole R, Petruzziello F, Menna G, Mangione A, Cianciulli E, Buffardi S, et al. Central nervous system complications during treatment of acute lymphoblastic leukemia in a single pediatric institution. Leuk Lymphoma. 2010;51(6):1063‑71.
  6. Ghali MGZ, Davanzo J, Leo M, Rizk E. Posterior reversible encephalopathy syndrome in pediatric patients: pathophysiology, diagnosis, and management. Leuk Lymphoma. 2019;60(10):2365‑72.
  7. Cordelli DM, Masetti R, Bernardi B, Barcia G, Gentile V, Biagi C, et al. Status epilepticus as a main manifestation of posterior reversible encephalopathy syndrome after pediatric hematopoietic stem cell transplantation. Pediatr Blood Cancer. 2012;58(5):785‑90.
  8. Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 2008;29(6):1036‑42.
  9. Tavares M, Arantes M, Chacim S, Júnior AC, Pinto A, Mariz JM, et al. Posterior reversible encephalopathy syndrome in children with hematologic malignancies. J Child Neurol. 2015;30(12):1669‑75.
  10. D’Angelo P, Farruggia P, Bello AL, Tropia S, Caselli D, Arico M. Reversible posterior leukoencephalopathy syndrome. J Pediatr Hematol Oncol. 2006;28(3).
  11. Marra A, Vargas M, Striano P, Del Guercio L, Buonanno P, Servillo G. Posterior reversible encephalopathy syndrome: the endothelial hypotheses. Med Hypotheses. 2014;82(5):619‑22.
  12. Morris EB, Laningham FH, Sandlund JT, Khan RB. Posterior reversible encephalopathy syndrome in children with cancer. Pediatr Blood Cancer. 2007;48(2):152‑9.
  13. Tambasco N, Mastrodicasa E, Salvatori C, Mancini G, Romoli M, Caniglia M, et al. Prognostic factors in children with PRES and hematologic diseases. Acta Neurol Scand. 2016;134(6):474‑83.
  14. Danhofer P, Tomečková M, Černá D, Zapletalová D, Horák O, Aulická Š, et al. Prognostic factors and seizure outcome in posterior reversible encephalopathy syndrome (PRES) in children with hematological malignancies and bone marrow failure: a retrospective monocentric study. Seizure. 19apr. J.-C.;72:1‑10.
  15. Dicuonzo F, Salvati A, Palma M, Lefons V, Lasalandra G, De Leonardis F, et al. Posterior reversible encephalopathy syndrome associated with methotrexate neurotoxicity: conventional magnetic resonance and diffusion-weighted imaging findings. J Child Neurol. 2009;24(8):1013‑8.
  16. Fukuyama T, Tanaka M, Nakazawa Y, Motoki N, Inaba Y, Higuchi T, et al. Prophylactic treatment for hypertension and seizure in a case of allogeneic hematopoietic stem cell transplantation after posterior reversible encephalopathy syndrome: Prophylactic treatment for PRES in HSCT. Pediatr Transplant. 2011;15(8):E169‑73.