产后第二天的后部可逆性脑病综合征（PRES）：一例病例报告及文献综述的经验教训
Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review.
摘要(中文译文)
可逆性后部脑病综合征（PRES）是一种少见的神经系统疾病，其特征为症状多样。这种短暂性的临床状况可能被低估，并被误诊为其他疾病，尤其是在产褥期患有重度子痫前期、子痫和HELLP（溶血、肝酶升高和血小板减少）综合征的孕妇中。我们借此将该罕见并发症贡献于文献，并强调PRES的恰当管理。一名孕妇（孕3产2）孕期经过正常。然而，她在妊娠29周5天时被诊断为重度子痫前期和HELLP综合征。因此，在我们的三级转诊医院，经患者同意后，她接受了医学终止妊娠。严重的是，该患者在产褥早期迅速出现精神状态改变。结果，基于脑磁共振成像（MRI）的典型表现，诊断为PRES。经过严格的多学科管理，临床状况在发病5天后改善，并在4个月随访后完全恢复，未遗留任何后遗症。总之，尽管PRES罕见，临床医生应具备相关知识并提高对妊娠期PRES的认识。重要的是，对于重度子痫前期后出现神经系统症状的孕妇，应考虑进行脑影像学检查。除早期诊断外，强烈建议在多学科团队协作下及时给予恰当治疗。针对这一少见疾病，需要开展更大病例系列的进一步研究。
Abstract
Posterior reversible encephalopathy syndrome (PRES) is an uncommon neurological disorder which is characterised by variable symptoms. The transient clinical condition may be underestimated and misdiagnosed as other conditions, especially, among pregnant women with severe preeclampsia, eclampsia, and HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome in the puerperium. We hereby contribute to the literature this rare complication and hightlight the appropriate management of PRES . A pregnant woman (gravida 3, parity 2) had a normal antenatal course. However, she was diagnosed with severe preeclampsia and HELLP syndrome at 29 weeks and 5 days of gestation. Therefore, she was indicated for a medical termination of pregnancy following a patient's consent at our tertiary referral hospital. Severely, the patient developed rapidly with altered mental health in early puerperium. In result, PRES was diagnosed based on a brain magnetic resonance imaging (MRI) evidence with typical findings. After a strict multidisciplinary management, the clinical condition improved after 5 days of onset and recovered completely after a 4-month follow-up without any sequelae. In summary, despite its rarity, clinicians ought to be knowledgeable and raise an aware of PRES during pregnancy. Importantly, a brain imaging modalities should be taken into account among pregnant women with neurological symptoms subsequent to severe preeclampsia. In addition to early diagnosis, a timely appropriate treatment with multidisciplinary team is strongly indicated. Further studies with a large case series are required for this uncommon entity.
如何引用
AMA
Anh Dinh Bao Vuong, Xuan Trang Thi Pham, Phuc Nhon Nguyen. Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review.. International journal of emergency medicine. 2024; doi:10.1186/s12245-024-00707-0.
APA
Anh Dinh Bao Vuong, Xuan Trang Thi Pham, Phuc Nhon Nguyen (2024). Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review.. International journal of emergency medicine. https://doi.org/10.1186/s12245-024-00707-0
GB/T 7714
Anh Dinh Bao Vuong, Xuan Trang Thi Pham, Phuc Nhon Nguyen. Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review.[J]. International journal of emergency medicine, 2024 doi:10.1186/s12245-024-00707-0.
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