Posterior reversible encephalopathy syndrome in an AIDS patient with acute renal failure and hypertension

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Olivia Bargiacchi
Anna M. Salerno
Antonella Rossati
Roberta Brondolo
Diego Brustia
Felicita Rosa
Giovanni Rizzo
Pietro L. Garavelli *
(*) Corresponding Author:
Pietro L. Garavelli | pietro.luigi.garavelli@maggioreosp.novara.it

Abstract

Introduction: The posterior reversible encephalopathy syndrome (PRES) is a neurological entity characterized by magnetic resonance imaging (MRI) evidence of bilateral subcortical edema in the occipital regions of the brain.
Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement.
Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

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