Posterior reversible encephalopathy syndrome in Henoch-Schonlein purpura induced by oral steroid therapy and hypertension

Abstract

An 11-year-old boy with Henoch-Schonlein purpura complicated by hypertension-induced encephalopathy is reported. Steroid therapy (oral prednisolone 2 mg/kg per day) was started immediately after diagnosis because of gastrointestinal involvement. A few days later the patient developed hypertension followed by generalized tonic-clonic seizures. A peripheral lesion in the posterior gray and white matter was seen on magnetic resonance imaging. The nature and location of the lesions and the normalization of the patient's magnetic resonance imaging reported a few months later was consistent with a posterior predominant parieto-occipital encephalopathy described in the literature as posterior reversible encephalopathy syndrome. The occurrence of this very rare syndrome in childhood requires close monitoring and normalization of blood pressure in patients in order to prevent central nervous system manifestations.