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Case Report

Reversible posterior encephalopathy syndrome on malignant hypertension secondary to congenital nephrotic syndrome (case report)

Lamiaa Chahidi El Ouazzani, Dalal Laoudiyi, Abdelhamid Jadib, Siradji Harouna, Kamilia Chbani, Siham Salam, Lahcen Ouzidane.

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Posterior reversible encephalopathy syndrome (PRES) is a rare complication, especially in children. Cerebral magnetic resonance imaging (MRI) is considered the reference examination to evoke this diagnosis.
We report the case of a 7-year-old boy presenting with a reversible posterior encephalopathy syndrome secondary to malignant arterial hypertension complicating CKD on congenital nephropathy, which presented with a tonic-clonic seizure and loss of consciousness, with a BP of 190/130mmHg in an apyretic context. Imaging revealed characteristic oedema of the white and grey matter in the form of multiple areas of T2 hyper signal and cortico-subcortical cortical temporo-occipital and frontal, of the caudate nucleus and bilateral lenticulars, of the brain stem and cerebellum about the PRES given the clinico radiological context.
The course of action was hospitalization in intensive care with stabilization and conditioning, and he was put on antihypertensive and anticonvulsant drugs.
Rigorous monitoring was required in our patient, and the evolution was very favourable.

Key words: Posterior reversible encephalopathy syndrome, malignant hypertension, CKD, congenital nephropathy, imaging

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