Case reportPosterior reversible encephalopathy syndrome in a child with bronchial asthma
Introduction
Posterior reversible encephalopathy syndrome (PRES) is a disorder usually associated with reversible radiological findings which involve the white matter and often gray matter of the parieto-occipital lobes, and characterized by seizures, altered mental state, visual abnormalities and headache [1], [2], [3]. It is caused by various conditions, including hypertension, eclampsia, immunosuppressive therapy, and renal failure. However, there have been no reports on PRES in children with bronchial asthma. We report a case with PRES which occurred during the treatment for severe asthmatic attack.
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Patient report
A previously healthy 4-year-old girl presented with wheezing and dyspnea. She was diagnosed as having bronchial asthma and was hospitalized. Although she was treated with intravenous hydrocortisone, continuous inhalation of β-2 stimulator and supplementary oxygen, her respiration state became worse. On the 2nd hospital day, she was admitted to an intensive care unit and general anesthesia with inhaled sevoflurane was performed in combination with drip infusion of methylprednisolone at the dose
Discussion
The causes of PRES are diverse, and the majority of patients have clinically serious diseases or conditions such as renal failure, chemotherapy against malignancy, and immunosuppression for liver, renal, or bone marrow transplantation [1], [2], [3]. However, there have been no reports of PRES occurring during the treatment of asthmatic attack like this patient. Bronchial asthma is a common disease, and steroids are often used for the treatment. To our knowledge, there are few reports that the
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