血液透析との関連が疑われ，再発したｒｅｖｅｒｓｉｂｌｅ　ｐｏｓｔｅｒｉｏｒ　ｌｅｕｋｏｅｎｃｅｐｈａｌｏｐａｔｈｙ　ｓｙｎｄｒｏｍｅ（ＲＰＬＳ）の１例

• 鷹津 久登

  岐阜市民病院第1内科, 腎臓病・血液浄化センター

• 佐野 浩毅

  岐阜市民病院第1内科, 腎臓病・血液浄化センター

• 三宅 泰次

  岐阜市民病院第1内科, 腎臓病・血液浄化センター

• 里見 和夫

  岐阜市民病院第1内科, 腎臓病・血液浄化センター

書誌事項

タイトル別名

• Relapsing episode of reversible posterior leukoencephalopathy syndrome occurred in a hemodialysis patient; a case report.

抄録

Reversible posterior leukoencephalopathy syndrome (RPLS) has been introduced by Hinchey et al., as a clinical entity which shows a reversible syndrome of headache, altered mental functions, seizures, and loss of vision associated with findings indicating predominantly posterior leukoencephalopathy on imaging studies. The present case was a 51-year-old woman who had been maintained on chronic hemodialysis therapy for 3 months. She developed disorientation, visual disturbance and seizure, and was then transferred to our institution. Magnetic resonance imaging (MRI) of the brain demonstrated bilateral white-matter abnormality suggestive of edema in the posterior regions of the cerebral hemisphere. She had history of hypertension and the chest X-ray demonstrated pulmonary congestion as well as cardiomegaly. Since high blood pressure and fluid retention were considered to be the cause of RPLS, we conducted intensive hemodialysis therapy to reduce body weight by 3kg. Thereafter, her mental status gradually became clear and visual disturbance improved in association with the disappearance of the edematous lesion in the posterior white-matter on MRI. She returned to the out-patient clinic and was maintained on hemodialysis. Six month later, she again developed disorientation and a shuffling gait. Blood pressure was high and cardiac size was enlarged. She was admitted again and her dry weight was reset to lower level. Then, her mental and neurological signs and MRI findings improved. The present case suggests that inappropriate fluid and blood pressure control may cause RPLS in a patient on hemodialysis therapy.

収録刊行物

• 日本透析医学会雑誌

  日本透析医学会雑誌 36 (6), 1227-1232, 2003

  一般社団法人 日本透析医学会

キーワード

• reversible posterior leukoencephalopathy syndrome (RPLS)
• chronic renal failure
• hemodialysis
• hypertension

詳細情報

• CRID: 1390001204676637696
• NII論文ID: 130003721724
• NII論文ID: 10011427190
• NII書誌ID: AN10432053
• DOI: 10.4009/jsdt.36.1227
• ISSN: 1883082X
• ISSN: 13403451
• Web Site: https://search.jamas.or.jp/link/ui/2003309484
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可