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증례 : 혈액투석 중인 만성 신부전 환자에서 발생한 Reversible Posterior Leukoencephalopathy Syndrome (A Case of Reversible Posterior Leukoencephalopathy Syndrome in Patient with Chronic Renal Failure) |
구영선(Young Sun Koo),김도희(Do Hee Kim),장윤경(Yoon Kyung Chang),양종오(Jong Oh Yang),강민규(Min Gyu Kang),황평주(Pyeong Joo Hwang),송창준(Chang June Song),이강욱(Kang Wook Lee),신영태(Young Tai Shin) |
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Abstract |
A Reversible Posterior Leukoencephalopathy Syndrome(RPLS) consists of neurologic symptoms and signs - headache, consciousness change, seizure, visual impairment - and brain imaging finding showing brain(espicially white matter) edema usually involving the posteior parietal-temporal-occipital areas. The causes are thought to be hypertensive encephalopathy, preeclampsia or eclampsia, renal failure with fluid overload and immunosuppressive agents such as cyclosporin A or FK506. RPLS may usually reversible if treated early by decreasing blood pressure and discontinuing offending drugs. A 23-year- old man had been hemodialyzed with chronic renal failure for two years. His blood pressure elevated to 240/150mmHg 3 days before admission and he complained of severe headache, vomiting, and total visual loss at the day of admission. Brain T2-weighted MRI imaging showed increased signal intensity involving the both parietal, posterior temporal, and occipital lobes. After antihypertensive and dexamethason treatment, a follow-up brain MRI performed on 7 days after admission showed nearly normalized findings and all symptoms including visual loss were recovered completely in one week. |
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