Abstract
Posterior reversible encephalopathy syndrome (PRES) has been reported to occur in 3.5-5.9% of children after renal transplantation, although the precise overall frequency in the pediatric population is unknown. As with adults, high blood pressure and the use of immunosuppressive drugs are common risk factors. The blood pressure should be managed more rapidly and more strictly in children, because the autoregulation of pediatric brain circulation is more vulnerable to high blood pressure than that of adults. We identified nine patients who developed PRES. The patients' ages ranged from 2 to 10 years (median: 6.3 years). Immunosuppressive therapy had been used at the onset of the syndrome in 8 patients. An alteration of consciousness and hypertension above the 99th percentile were observed in all patients. In the group with a poor neurological prognosis, it was difficult to manage the blood pressure, and the time during which the blood pressure was lower than the 99th percentile was short. Our study demonstrates that the aggressive management of hypertension and underlying disease in the early phase of PRES is very important.
