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

Article type: Research Article

Authors: Pavlou, Evangelos | Hatzistilianou, Maria | Stamou, Maria | Fidani, Liana | Charitandi, Afrodites | Athanasiadou, Fani

Affiliations: 2nd Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece

Note: [] Correspondence: Dr. Pavlou Evangelos, M.D., Eleones Pilea 55535, Thessaloniki Greece. Tel.: +30 231 099 3522; Fax: +30 231 099 3514; E-mail: [email protected]

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.

Keywords: Henoch-Schonlein purpura, childhood, posterior encephalopathy

DOI: 10.3233/JPN-2010-0424

Journal: Journal of Pediatric Neurology, vol. 8, no. 4, pp. 421-424, 2010