Posterior reversible encephalopathy syndrome in an HIV-infected patient on antiretroviral treatment: what is the risk factor?

Birner, Barbara; Hirzel, Cédric; Wagner, Franca; Waldegg, Gabriel (2018). Posterior reversible encephalopathy syndrome in an HIV-infected patient on antiretroviral treatment: what is the risk factor? BMJ case reports, 2018 BMJ Publishing Group 10.1136/bcr-2017-221998

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Posterior reversible encephalopathy syndrome (PRES) is a rare but well-described syndrome associated with a high morbidity and a substantial mortality. We present an illustrative case of an HIV-infected but virologically suppressed patient who complained of visual impairment accompanied by severe headache and epileptic seizures. The cerebral CT scan and the follow-up cranial MRI confirmed the diagnosis of PRES. Unlike the cases of HIV-infected patients with PRES published so far, our patient suffered neither from advanced immunodeficiency nor from opportunistic infection or from any other evident predisposing factor. This case highlights that the absence of classical risk factors does not exclude the diagnosis of PRES. We discuss the hypothesis that in accordance with the new pathophysiological theory, persistent HIV-associated cerebrovascular reactivity in combination with endothelial dysfunction may represent an undetected risk factor for the development of PRES in virologically and immunologically stable patients.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Birner, Barbara; Hirzel, Cédric and Wagner, Franca

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-790X

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

09 Apr 2018 14:14

Last Modified:

09 Apr 2018 14:14

Publisher DOI:

10.1136/bcr-2017-221998

PubMed ID:

29301799

Uncontrolled Keywords:

HIV / AIDS epilepsy and seizures hypertension neuroimaging

BORIS DOI:

10.7892/boris.108747

URI:

https://boris.unibe.ch/id/eprint/108747

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