Posterior reversible encephalopathy syndrome following liver transplantation: A case report and literature review

doi:10.3969/j.issn.1004-583X.2025.05.013

Abstract

Abstract:

Objective To investigate the clinical characteristics and treatment strategies for posterior reversible encephalopathy syndrome (PRES) following liver transplantation. Methods The clinical manifestations, imaging features, treatment and prognosis of a PRES patient after liver transplantation were retrospectively analyzed, and the related literatures were reviewed. Results A 50-year-old female patient presented with unexplained status epilepticus after liver transplantation. Clinical evaluation and imaging studies confirmed the diagnosis of calcineurin inhibitor (CNI)-associated PRES. After promptly adjusting for the immunosuppressive regimen (replacing CNIs with sirolimus), the patient's neurological symptoms resolved completely without sequelae. Conclusion The occurrence of PRES after liver transplantation is closely related to CNI immunosuppressive therapy. Early recognition and timely adjustment for the immunosuppressive regimen are crucial for improving the prognosis.

Key words: posterior reversible encephalopathy syndrome, liver transplantation, immunosuppressive agents

CLC Number:

R742

Wang Dongxia, Zhang Dong, Song Shifei, Yang Yimin. Posterior reversible encephalopathy syndrome following liver transplantation: A case report and literature review[J]. Clinical Focus, 2025, 40(5): 454-457.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.05.013

http://www.lchc.cn/EN/Y2025/V40/I5/454

Figures/Tables 1

Fig.1 Cranial imaging findings after liver transplantation a1~2.Low density in bilateral frontal lobe and left parietal lobe (brain CT on the second day after operation); (b) Large-scale low densities in the bilateral frontal, temporal, parietal and occipital lobes (brain CT on the 5th day after operation); c-e.Slice-like abnormal signals in bilateral frontal parietal occipital lobe and left temporal lobe subcortical white matter (brain magnetic resonance imaging on the 12th day after operation); f1~3.Large-scale low densities in bilateral frontotemporal parietal occipital lobes (brain CT on the 18th day after operation ); g. Abnormal signals in the left temporal occipital cortex (cranial magnetic resonance imaging 3 months after surgery); h. Abnormal signals in the left temporal occipital cortex (brain magnetic resonance imaging 5 months after surgery)

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