Reversible posterior encephalopathy syndrome on malignant hypertension secondary to congenital nephrotic syndrome (case report)

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a fairly rare complication, and even more so in children. Cerebral magnetic resonance imaging (MRI) is considered the reference examination to evoke this diagnosis. We report the case of a 7-year-old boy presenting with a reversible posterior encephalopathy syndrome secondary to malignant arterial hypertension complicating CKD on congenital nephropathy, which presented with a tonic-clonic seizure and loss of consciousness, with a BP of 190/130mmHg in an apyretic context . Imaging revealed characteristic edema of the white and gray matter in the form of multiple areas of T2 hyper signal and cortico-subcortical cortical temporo-occipital and frontal, of the caudate nucleus and bilateral lenticulars, of the brain stem and cerebellum in relation to the PRES given the clinico radiological context. The course of action was hospitalization in intensive care with stabilization and conditioning, and was put on antihypertensive and anticonvulsant drugs A rigorous monitoring was required in our patient and the evolution was very favorable.