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Bir Lupus Nefriti Hastasında Siklofosfamid Tedavisi Sonrası Gelişen Geri Dönüşümlü Posterior Lökoensefalopati Sendromu

Development of Reversible Posterior Leukoencephalopathy Syndrome after Cyclophosphamide Treatment in a Patient with Lupus Nephritis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.19

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Renal involvement in systemic lupus erythematosus is a frequent and serious complication that significantly increases morbidity and mortality. Despite all studies and usage of new drugs, treatment of lupus nephritis continues to be a problem. Diffuse proliferative lupus nephritis has a poor prognosis and aggressive treatment must be undertaken. Cyclophosphamide is commonly used in treatment despite its side effects. Reversible posterior leucoencephalopathy syndrome is a clinico-radiological syndrome manifested by blood pressure elevation, headache, visual disturbances, confusion, seizures and sometimes focal neurological signs that can develop due to usage of cytotoxic drugs. We present a case of lupus nephritis in which reversible posterior leucoencephalopathy syndrome developed after intravenous cyclophosphamide administration and recovered spontaneously by symptomatic treatment in this article.
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Abstract (Original Language): 
Sistemik lupus eritematozus’ta böbrek tutulumu, morbidite ve mortaliteyi anlamlı derecede arttıran sık ve ciddi bir komplikasyondur. Lupus nefritinin tedavisi tüm çalışmalara ve yeni ilaçların kullanılmasına rağmen önemli bir problem olmaya devam etmektedir. Diffüz proliferatif lupus nefriti en kötü prognoza sahiptir ve agresif tedavi edilmesi gerekmektedir. Tedavide istenmeyen yan etkileri olmasına rağmen siklofosfamid yaygın olarak kullanılmaktadır. Reversibl (geri dönüşümlü) posterior lökoensefalopati sendromu sitotoksik ilaçların kullanılmasına bağlı olarak ortaya çıkabilen, klinik olarak ani kan basıncı yüksekliği ile birlikte baş ağrısı, görme bozuklukları, konfüzyon ve nöbetler ile karakterize, bazen fokal nörolojik bulguların da eşlik ettiği bir klinikoradyolojik sendromdur. Yazımızda lupus nefriti tanısı alan, damardan siklofosfamid uygulaması sonrası geri dönüşümlü posterior lökoensefalopati sendromu gelişen ve semptomatik tedavi ile kendiliğinden düzelen bir olgu sunulacaktır.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_20_pp_104-107.pdf
  • 1
104-107
  • Turkish

REFERENCES

References: 

1. D’Cruz DP, Khamashta MA, Hughes GR: Systemic lupus
erythematosus. Lancet 2007; 369: 587-596
2. Austin HA, Balow JE: Treatment of lupus nephritis. Semin Nephrol
2000; 20:265-276
3. Petri M: Cyclophosphamide: New approaches for systemic lupus
erythematosus. Lupus 2004; 13: 366-371
4. Garg RK: Posterior leukoencephalopathy syndrome. Postgrad Med
J 2001; 77: 24-28
5. Min L, Zwerling J, Ocava LC, Chen IH, Putterman C: Reversible
posterior leukoencephalopathy in connective tissue diseases. Semin
Arthritis Rheum 2006; 35: 388-395
6. Hughes RL: Cyclosporine-related central nervous system toxicity in
cardiac transplantation. N Engl J Med 1990; 323: 420-421
7. Kemper MJ, Spartà G, Laube GF, Miozzari M, Neuhaus TJ:
Neuropsychologic side-effects of tacrolimus in pediatric renal
transplantation. Clin Transplant 2003; 17: 130-134
8. Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A,
Pessin MS, Lamy C, Mas JL, Caplan LR: A reversible posterior
leukoencephalopathy syndrome. N Engl J Med 1996; 334: 494-500
9. Casey SO, Sampaio RC, Michel E, Truwit CL: Posterior reversible
encephalopathy syndrome utility of FLAIR imaging in the detection
of cortical and subcortical lesions. AJNR Am J Neuroradiol 2000;
21: 1119-1206
10. Obeid T, Shami A, Karsou S: The role of seizures in reversible
posterior leukoencephalopathy. Seizure 2004; 13: 277-281
11. Muscal E, Brey RL: Neurologic manifestations of systemic lupus
erythematosus in children and adults. Neurol Clin 2010; 28:
61-73
12. Sibley JT, Olszynski WP, Decoteau WE, Sundaram MB: The
incidence and prognosis of central nervous system disease in
systemic lupus erythematosus. J Rheumatol 1992; 19: 47-52
13. Sibbitt WL Jr, Sibbitt RR, Griffey RH, Eckel C, Bankhurst AD:
Magnetic resonance and computed tomographic imaging in the
evaluation of acute neuropsychiatric disease in systemic lupus
erythematosus. Ann Rheum Dis 1989; 48: 1014-1022

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