Neuroimaging fndings of posterior reversible encephalopathy syndrome (PRES) following haematopoietic stem cell transplantation in paediatric recipients

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dc.authorid0000-0001-8036-547Xen_US
dc.contributor.authorAtça, Ali Önder
dc.contributor.authorErok, Berrin
dc.contributor.authorAydoğdu, Selime
dc.date.accessioned2022-01-17T07:28:13Z
dc.date.available2022-01-17T07:28:13Z
dc.date.issued2021en_US
dc.departmentFakülteler, Tıp Fakültesi, Temel Tıp Bilimlerien_US
dc.description.abstractBackground: Haematopoietic stem cell transplantation (HSCT) is used worldwide in various malignant and nonmalignant childhood diseases, including haematologic, genetic, autoimmune and metabolic disorders, and is the only curative treatment for many of these illnesses. The survival rates of many childhood diseases have been increased due to HSCT treatment. However, associated complications are still important for management. Central nervous system (CNS) complications in paediatric HSCT recipients can be associated with high morbidity and signifcantly contribute to mortality. Posterior reversible encephalopathy syndrome (PRES) is one of the most common CNS complications in patients with neurological symptoms following HSCT. Magnetic resonance imaging (MRI) is the modality of choice and shows typical bilateral vasogenic oedema at the posterior parts of the cerebral hemispheres; however, various atypical imaging manifestations can also occur. In this study, we retrospectively examined CNS complications in our paediatric HSCT recipients with a focus on the typical and atypical neuroimaging manifestations of PRES following HSCT. Methods: We retrospectively reviewed the medical records of 300 consecutive paediatric HSCT recipients from January 2014 to November 2018. A total of 130 paediatric HSCT recipients who experienced neurological signs and symptoms and were evaluated with neuroimaging studies following HSCT were enrolled in the study. The timing of CNS complications was defned according to immune status, including the pre-engraftment period (<30days after HSCT), the early postengraftment period (30–100days after HSCT), and the late postengraftment period (>100days after HSCT), which were defned as phases 1, 2 and 3, respectively. Results: Overall, 130 paediatric HSCT recipients experienced neurological signs and symptoms and therefore underwent neuroimaging examinations. Among these 130 patients, CNS complications were present in 23 patients (17.6%, 23/130), including 13 (56.5%) females and 10 (43.5%) males with a median age of 8.0 years (range, 8months to 18.0 years). Among these 23 patients, 14 cases of PRES (60.9%), 5 (21.7%) cases of leukoencephalopathy, 3 cases of acute subdural haemorrhage (ASDH) (13%) and 1 (4.3%) case of fungal CNS infection were identifed by neuroimaging. On MRI, typical parietooccipital vasogenic oedema was present in 78.5% of the PRES cases (11/14). The following atypical neuroimaging manifestations were observed: isolated involvement of the bilateral frontal lobes in 1 case, isolated cerebellar vermis involvement in 1 case, and isolated basal ganglia involvement in 1 case. Restricted difusion associated with cytotoxic damage was demonstrated in 2 of 14 cases, one of which also showed subacute cytotoxic injury with ADC pseudonormalization. Conclusion: Paediatric HSCT recipients presenting with CNS signs and symptoms should be evaluated by neuroimaging studies for timely diagnosis and early management. PRES is the most common CNS complication and may present with atypical MRI manifestations, which should not dissuade a PRES diagnosis in appropriate clinical settings.en_US
dc.identifier.citationAtça, A. Ö., Erok, B., & Aydoğdu, S. (2021). Neuroimaging findings of posterior reversible encephalopathy syndrome (PRES) following haematopoietic stem cell transplantation in paediatric recipients. BMC pediatrics, 21(1), 1-12.en_US
dc.identifier.endpage12en_US
dc.identifier.issue1en_US
dc.identifier.scopus2-s2.0-85116814825
dc.identifier.scopusqualityN/A
dc.identifier.startpage1en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12939/2194
dc.identifier.volume21en_US
dc.identifier.wosWOS:000705384000001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorErok, Berrin
dc.language.isoen
dc.publisherBMCen_US
dc.relation.isversionof10.1186/s12887-021-02890-yen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHSCTen_US
dc.subjectCNSen_US
dc.subjectPRESen_US
dc.titleNeuroimaging fndings of posterior reversible encephalopathy syndrome (PRES) following haematopoietic stem cell transplantation in paediatric recipients
dc.typeArticle

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