Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Posterior reversible encephalopathy syndrome during intravenous immunoglobulin therapy in Guillain-Barré syndrome

Eri Watanabe, M.D.1), Nobuhiro Ido, M.D.1), Tomoko Saito, M.D.1), Haruhisa Kato, M.D., Ph.D.1), Hiroo Terashi, M.D., Ph.D.1) and Hitoshi Aizawa, M.D., Ph.D.1)

1) Department of Neurology, Tokyo Medical University

A 63-year-old woman was diagnosed with Guillain-Barré syndrome (GBS), and intravenous immunoglobulin (IVIg) therapy was initiated. On the second day of IVIg therapy, she became less alert (JCS III-200) and had hyponatremia. Brain MRI showed vasogenic edema in bilateral occipital lobes, which disappeared afterwards. Her clinical course and MRI findings were consistent with those of posterior reversible encephalopathy syndrome (PRES). As a result of considering the timing of the onset of GBS and PRES and the degree of hyponatremia and hypertension in some documented patients, the cause of PRES onset in this case is considered to be IVIg therapy itself and IVIg therapyinduced hyponatremia.
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(CLINICA NEUROL, 61: 12|17, 2021)
key words: Guillain-Barré syndrome, posterior reversible encephalopathy syndrome, intravenous immunoglobulin therapy

(Received: 5-Apr-20)