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. 2022 Mar 1;44(2):54-59.
doi: 10.1097/MPH.0000000000002153.

Posterior Reversible Encephalopathy Syndrome: Incidence and Clinical Characteristics in Children With Cancer

Katherine R Sommers  1 , Jodi Skiles  2 , Brian Leland  3 , Courtney M Rowan  3
Affiliations

Posterior Reversible Encephalopathy Syndrome: Incidence and Clinical Characteristics in Children With Cancer

Katherine R Sommers et al. J Pediatr Hematol Oncol. .

Abstract

The etiology and outcomes of posterior reversible encephalopathy syndrome (PRES) in children with cancer are not well understood. We aim to determine the incidence of PRES, describe associated morbidity and mortality, and better understand risk factors in this patient population. A total of 473 children with a hematologic malignancy or postallogeneic hematopoietic cell transplantation between June 2015 and June 2020 were screened for PRES to determine incidence and whether age or underlying diagnosis are associated with development of PRES. We conducted a case-control study to evaluate whether comorbidities or chemotherapeutic agents are associated with PRES. Children with PRES were matched with 2 controls based on age and underlying diagnosis to identify additional risk factors. Fourteen patients developed PRES, with an incidence of 5.9/1000 people/year. Those diagnosed with PRES had commonly described PRES symptoms: hypertension, seizures, nausea/vomiting, altered mental status, and headaches. All patients received an magnetic resonance imaging, and most had findings consistent with PRES. Hematopoietic cell transplantation was associated with the development of PRES. The use of Etoposide was associated with PRES but comorbidities, steroids and calcineurin inhibitors were not. While PRES was infrequent in this population, it is associated with high morbidity and mortality, with ICU admissions and an overall hospital mortality, because of secondary causes, of 29%.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:. Percentage of symptoms experienced by patients with PRES.
These symptoms were assessed for all patients with the diagnosis of PRES. Results are presented as percentage of patients with PRES.
Figure 2:
Figure 2:. Percentage of MRI findings associated with patients with PRES.
MRI findings were assessed in patients with a diagnosis of PRES. The results are presented as percentage of patients with PRES.
See this image and copyright information in PMC

References

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