34 YEAR OLD FEMALE, RECENT PREGNANCY,HAS SIGNIFICANT HYPERTENSIVE EPISODES AND IS ADMITTED. LABS SHOW MG OF 0.8. SHE HAS SLE ON STEROIDS AND TACROLIMUS. HX OF ITP NEEDING IVIG. WHAT(IN HER) ARE CAUSES OF POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME?
Pregnancy 22%
IVIG 25%
Tacrolimus 58%
Steroids 11%
Tacrolimus 58%
Steroids 11%
SLE 38%
Hypomagnesemia 19%
Hmm... tough question but good try all. In this particular patients, unfortunately she had all the risk factors and potentially known causes of Posterior Reversible Leukocencephalopathy Syndrome(PRES).
Known causes of PRES are: Pregnancy- pre eclampsia or eclampsia. SLE, Vasculitis, Uncontrolled hypertension from essential causes or secondary causes like medications ( steroids, tacrolimus), drug induced from chemotherapy like vincristine, anti VEGF agents, steroids, CNIs, IVIG are all risk factors.
TTP, HUS are known risk factors
Interestingly, hypomagnesemia, and hypocalcemia are noted to be risk factors as well.
Ref:
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