신증후군 환자에서 스테로이드 충격요법과 경구용 면역억제제 치료 중 발생한 가역성 후백질뇌병증 1례 |
서주희, 신정욱, 김지홍, 윤춘식 |
1연세대학교 의과대학 소아과학교실 2연세대학교 의과대학 소아과학교실 3연세대학교 의과대학 소아과학교실 4연세대학교 의과대학 진단방사선과학교실 및 신장질환연구소 |
A Case of Reversible Posterior Leukoencephalopathy Syndrome during Methylprednisolone Pulse and Cyclophosphamide Therapy in a Child with Nephrotic Syndrome |
Joo Hee Seo, Jung Wook Shin, Ji Hong Kim, Choon Sik Yoon |
1Departments of Pediatrics, Yonsei University, College of Medicine 2Departments of Pediatrics, Yonsei University, College of Medicine 3Departments of Pediatrics, Yonsei University, College of Medicine 4Departments of Diagnostic Radiology and The Institute of Kidney Disease, Yonsei University, College of Medicine |
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ABSTRACT |
The syndrome of reversible posterior leukoencephalopathy syndrome(RPLS) is characterized clinically by acute neurologic signs such as headache, vomiting, confusion, seizures, and visual abnormalities. Radiologically, abnormalities consistent with reversible white matter edema in the occipital and parietal lobes are characteristic. RPLS has often been associated with various systemic disorders, such as hypertensive encephalopathy, eclampsia, and the use of intravenous or intrathecal immunosuppressive drugs. We report a case of RPLS that occurred after intravenous steroid pulse therapy and treatment with oral cyclophosphamide in a child with nephrotic syndrome, and we emphasize the importance of early recognition of RPLS in the treatment of nephrotic syndrome and appropriate management to prevent permanent neurologic disability. |
Key words:
Reversible posterior leukoencephalopathy syndrome | Nephrotic syndrome | Steroid pulse therapy | Cyclophosphamide |
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