Korean Journal of Nephrology 2001;20(1):143-146.

증례 : Nephrotic Syndrome 을 동반한 Down Syndrome 환자에서 Steroid 투여 중 발생한 Reversible Posterior Leukoencephalopthy Syndrome 1 예 (A Case of Reversible Posterior Leukoencepalopathy Syndrome during Steroid Therapy in a Down Syndrome with Nephrotic Syndrome)

이지은(Ji Eun Lee),김병수(Byung Soo Kim),이호일(Ho Il Lee),최민석(Min Suk Choi),정성우(Sung Woo Chung),이승헌(Seung Hun Lee),최의진(Euy Jin Choi),방병기(Byung Kee Bang)

Abstract

The reversible posterior leukoencephalopathy syndrome usually includes seizure, headache, altered mental status, and blindness, often associated with hypertension and immunosuppressants. The authors discuss a 16-year-old female with Down syndrome who had nephrotic syndrome with severe headache, intermittent blindness, and seizures, after treated with prednisolone. The patient had a generalized tonic-clonic seizure at 8 days after prednisolone. A CT scan of the head revealed symmetrical multifocal low densities in the subcortical region of both parieto-occipital, frontal, temporal lobe. Magnetic resonance scanning revealed white matter lesions in the subcortices of the parietal, frontal and occipital lobes. The condition improved when prednisolone was discontinued. Follow-up image after 3 weeks shows nearly complete resolution of white matter and gray matter abnormalities on axial T2-weighted MR images. This episode might be caused by prednisolone because the clinical course and laboratory data revealed neither inflammation nor other causative factors.