Clinical Rheumatology

, Volume 26, Issue 10, pp 1761–1763 | Cite as

Henoch–Schönlein purpura nephritis complicated by reversible posterior leukoencephalopathy syndrome

  • Daimei Sasayama
  • Yasuhiro Shimojima
  • Takahisa Gono
  • Kazuma Kaneko
  • Masayuki Matsuda
  • Shu-ichi Ikeda
Case Report

Abstract

We report a young female patient with Henoch–Schönlein purpura (HSP) nephritis complicated by reversible posterior leukoencephalopathy syndrome (RPLS). The patient suddenly showed generalized seizures and cortical blindness with severe hypertension due to renal insufficiency approximately 1 year after cessation of corticosteroid treatment for HSP nephritis. Magnetic resonance imaging (MRI) demonstrated bilateral abnormal signals mainly in the cerebellum and white matter of the occipital lobe. Clinical symptoms quickly improved in conjunction with disappearance of abnormal signals on brain MRI after starting control of hypertension and continuous hemodiafiltration with steroid pulse therapy and plasmapheresis. RPLS may be caused by vasculitis and also by hemodynamic change due to severe hypertension in HSP, particularly in patients with nephropathy. In such cases intensive treatment should be performed as soon as possible to avoid neurological sequelae.

Keywords

Continuous hemodiafiltration Henoch–Schönlein purpura Hypertension Renal insufficiency Reversible posterior leukoencephalopathy syndrome 

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Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Daimei Sasayama
    • 1
  • Yasuhiro Shimojima
    • 1
  • Takahisa Gono
    • 1
  • Kazuma Kaneko
    • 1
  • Masayuki Matsuda
    • 1
  • Shu-ichi Ikeda
    • 1
  1. 1.Third Department of MedicineShinshu University School of MedicineMatsumotoJapan

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