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Post-streptococcal glomerulonephritis leading to posterior reversible encephalopathy syndrome: a case report

机译:链球菌后肾小球肾炎导致后可逆性脑病综合征:一例报告

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Background Posterior reversible encephalopathy syndrome is a clinical radiographic syndrome of heterogeneous etiologies. Developing hypertensive encephalopathy following post-streptococcal glomerulonephritis is a known but uncommon manifestation and developing posterior reversible encephalopathy syndrome in such a situation is very rare. We report a case with contrast-enhanced computed tomography and magnetic resonance imaging findings of posterior reversible encephalopathy syndrome in the background of acute post-streptococcal glomerulonephritis. Case presentation A thirteen- year -old Sri Lankan boy presented with a focal fit by way of secondary generalization with duration of 10?minutes, and developed 2 similar fits subsequently following admission. He later developed severe hypertension with evidence of glomerulonephritis, which was diagnosed as acute post-streptococcal glomerulonephritis. A contrast-enhanced computed tomography imaging of brain done on day-3 revealed non-enhancing low-attenuating areas in fronto -parietal regions. A T2 weighted film of magnetic resonance imaging was done on day-10 of the admission and found to have linier sub-cortical hyper intensities in both parietal regions which were compatible with the radiological diagnosis of posterior reversible encephalopathy syndrome. Conclusion Post-streptococcal glomerulonephritis is an important cause of acute nephritic syndrome especially in children. This case report illustrates a rare association of posterior reversible encephalopathy syndrome in a patient with post-streptococcal glomerulonephritis.
机译:背景技术后可逆性脑病综合征是一种临床上的影像学综合征,病因多样。链球菌性肾小球肾炎后发展为高血压脑病是一种已知但不常见的表现,在这种情况下发展为后可逆性脑病综合征的情况非常罕见。我们报告的急性后链球菌性肾小球肾炎的背景可逆性脑病综合征的对比增强计算机断层扫描和磁共振成像发现。病例报告一名十三岁的斯里兰卡男孩通过次要概括进行了一次焦点拟合,持续时间为10分钟,并在入院后进行了两次类似的拟合。后来他发展出严重的高血压,并伴有肾小球肾炎的证据,被诊断为急性链球菌性肾小球肾炎。在第3天进行的脑部对比增强计算机断层扫描成像显示,额顶区域无增强的低衰减区域。入院第10天进行了T2加权磁共振成像,发现两个顶叶区皮层下皮质高强度均与后可逆性脑病综合征的放射学诊断相符。结论链球菌性肾小球肾炎是引起急性肾病综合征的重要原因,尤其是儿童。该病例报告说明了链球菌后肾小球性肾炎患者罕见的后可逆性脑病综合征。

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