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Risk factor analysis of posterior reversible encephalopathy syndrome after allogeneic hematopoietic SCT in children

Bone Marrow Transplantation volume 49, pages 1538–1540 (2014)Cite this article

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Posterior reversible encephalopathy syndrome (PRES) is a clinical–neuroradiological entity characterized by seizures, headache, altered mental status and visual disturbances associated with typical transient lesions on magnetic resonance imaging (MRI).1,2 Allogeneic hematopoietic SCT (allo-HSCT) is associated with a large spectrum of neurological complications including PRES.3,4 The prompt recognition of PRES is crucial for starting symptomatic and life-supporting treatment and the proper management of the patient. Until now, a comprehensive assessment of predisposing factors for PRES in transplanted children has never been performed. The aim of this study was to identify the risk factors for PRES in pediatric patients who underwent allo-HSCT.

We reviewed database records of 313 consecutive allo-HSCT performed at the Pediatric HSCT Unit of Sant’Orsola-Malpighi Hospital in Bologna and of Spedali Civili in Brescia between January 2000 and November 2010. Patients who experienced PRES were retrospectively identified by examining reported clinical manifestations and computerized records of radiological examinations. The diagnosis of PRES was established on the basis of typical neuroimaging findings of cortical and subcortical vasogenic edema. Clinical manifestations included consciousness impairment, seizure activity, headaches, visual abnormalities, nausea/vomiting and focal neurological signs.2 An expert pediatric neuroradiologist reviewed MRI images of all cases.

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Author notes

  1. D Zama and R Masetti: These authors contributed equally to this work.

Authors and Affiliations

  1. Pediatric Oncology and Haematology Unit "Lalla Seràgnoli", Departement of Pediatrics, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy

    D Zama, R Masetti, F Vendemini, A Prete, R Rondelli & A Pession

  2. Pediatric Neurology Unit, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy

    D M Cordelli & E Franzoni

  3. Child Neuropsychiatry, Regional Epilepsy Center, Brescia, Italy

    L Giordano & G Milito

  4. Pediatric Oncology-Haematology and BMT Unit, Ospedale dei Bambini, Spedali Civili, Brescia, Italy

    F Porta

Authors
  1. D Zama
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  2. R Masetti
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  3. D M Cordelli
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  4. F Vendemini
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  5. L Giordano
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  6. G Milito
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  7. E Franzoni
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  8. F Porta
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  9. A Prete
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  10. R Rondelli
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  11. A Pession
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Corresponding author

Correspondence to D Zama.

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Zama, D., Masetti, R., Cordelli, D. et al. Risk factor analysis of posterior reversible encephalopathy syndrome after allogeneic hematopoietic SCT in children. Bone Marrow Transplant 49, 1538–1540 (2014). https://doi.org/10.1038/bmt.2014.182

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