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Reversible posterior leukoencephalopathy in a patient with Wegener granulomatosis

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Abstract

A 14-year-old girl with rapidly progressive glomerulonephritis was transferred to our hospital because of acute renal failure. A diagnosis of Wegener granulomatosis was made according to the symptom triad of a renal biopsy demonstrating crescentic glomerulonephritis, severe sinusitis, and serological findings of raised proteinase 3 anti-neutrophil cytoplasmic antibody level. In spite of combination therapy with methylprednisolone, cyclophosphamide, and plasma exchange, her renal function gradually deteriorated. Thereafter, she suffered a severe headache and generalized seizures. Brain computed tomography (CT) scan revealed bilateral low-density areas in the parieto-occipital lobes. Magnetic resonance imaging (MRI) disclosed a high-intensity area on T2-weighted images and a low-signal intensity area on T1-weighted images in the same lesion. Follow-up brain CT scan 3 weeks and MRI 2 months after the first studies showed complete resolution of the abnormal lesions, which indicated reversible posterior leukoencephalopathy syndrome. In addition to renal failure, hypertension, and cyclophoshamide, the primary disease may have played a role in the development of this uncommon syndrome in our patient.

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References

  1. Hinchey J, Chaves C, Appignani BA, Breen J, Pao L, Wang A, Pessin MS, Lamy C, Mas JL, Caplan LR (1996) A reversible posterior leukoencephalopathy syndrome. N Engl J Med 234:494–500

    Article  Google Scholar 

  2. Mukherjee P, McKinstry RC (2001) Reversible posterior leukoencephalopathy syndrome: evaluation with diffusion-tensor MR imaging. Radiology 219:756–765

    CAS  PubMed  Google Scholar 

  3. Saatci I, Topaloglu (1994) Cranial computed tomographic findings in a patient with hypertensive encephalopathy in acute poststreptococcal glomerulonephritis. Turk J Pediatr 36:325–328

    CAS  PubMed  Google Scholar 

  4. Singh N, Bonham A, Fukui M (2000) Immunosuppressive-associated leukoencephalopathy in organ transplant recipients. Transplantation 69:467–472

    CAS  PubMed  Google Scholar 

  5. Edwards MJJ, Walker R, Vinnicombe S, Barlow C, MacCallum P, Foran JM (2001) Reversible posterior leukoencephalopathy syndrome following CHOP chemotherapy for diffuse B-cell lymphoma. Ann Oncol 12:1327–1329

    Article  CAS  PubMed  Google Scholar 

  6. Belostotsky VM, Shah V, Dillon MJ (2002) Clinical features in 17 paediatric patients with Wegener granulomatosis. Pediatr Nephrol 17:754–761

    Article  PubMed  Google Scholar 

  7. Rottem M, Fauci AS, Hallahan CW, Kerr GS, Lebovics R, Leavitt RY, Hoffman GS (1993) Wegener granulomatosis in children and adolescents: clinical presentation and outcome. J Pediatr 122:26–31

    CAS  PubMed  Google Scholar 

  8. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS (1992) Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 116:488–498

    CAS  PubMed  Google Scholar 

  9. Savage COS (2001) ANCA-associated renal vasculitis. Kidney Int 60:1614–1627

    Article  CAS  PubMed  Google Scholar 

  10. Ellis EN, Wood EG, Berry P (1995) Spectrum of disease associated with anti-neutrophil cytoplasmic auto antibodies in pediatric patients. J Pediatr 126:40–43

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Toshiyuki Ohta, Takashi Sakano, Mami Shiotsu, Takeki Furue, Hideyuki Ohtani & Yoshihisa Kinoshita

  2. Department of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Tatsuya Mizoue & Katsuzo Kiya

  3. Dialysis Center, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Issei Tanaka

  4. Department of Pediatrics, Hiroshima Prefectural Hospital, 1–5-54 Ujinakanda, Minami-ku, Hiroshima 734–8530, Japan

    Toshiyuki Ohta

Authors
  1. Toshiyuki Ohta
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  2. Takashi Sakano
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  3. Mami Shiotsu
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  4. Takeki Furue
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  5. Hideyuki Ohtani
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  6. Yoshihisa Kinoshita
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  7. Tatsuya Mizoue
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  8. Katsuzo Kiya
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  9. Issei Tanaka
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Correspondence to Toshiyuki Ohta.

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Ohta, T., Sakano, T., Shiotsu, M. et al. Reversible posterior leukoencephalopathy in a patient with Wegener granulomatosis. Pediatr Nephrol 19, 442–444 (2004). https://doi.org/10.1007/s00467-003-1286-y

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  • DOI: https://doi.org/10.1007/s00467-003-1286-y

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