Posterior reversible encephalopathy syndrome related to COVID‐19 in a child

• Published in: Pediatrics International Vol. 64; no. 1; pp. e14908 - n/a
• Main Authors: Arslan, Gazi, Besci, Tolga, Karaca, Ömer, Aylan Gelen, Sema
• Format: Journal Article Web Resource
• Language: English
• Published: Australia John Wiley & Sons, Inc 01.01.2022; Blackwell Publishing Ltd
• Subjects: Brain - diagnostic imaging; Child; children; COVID-19; Encephalopathy; Humans; Magnetic Resonance Imaging; Pediatrics; Posterior Leukoencephalopathy Syndrome - diagnosis; Posterior Leukoencephalopathy Syndrome - etiology; posterior reversible encephalopathy syndrome; SARS-CoV-2; COVID-19; posterior reversible encephalopathy syndrome; SARS-CoV-2; children
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.14908

Seizure, encephalopathy, headache, cerebellar ataxia, drowsiness, and dizziness have also been reported with COVID-19 in children.3 The underlying mechanisms of PRES in COVID-19 have not been well described, but the pathophysiological changes seen in SARS-CoV-2 infection are important risk factors for PRES. Patients with COVID-19 may develop macrophage activation syndrome with fever and increased ferritin, D-Dimer and TNF-α levels. Tumor Necrosis Factor-alpha (TNF-α) increases vascular permeability and upregulates vascular endothelial growth factor in the presence of hypoxemia; moreover, it causes endothelial injury, which has also been implicated in PRES.4 In addition, SARS-CoV 2 may trigger cerebrovascular endothelial dysfunction and blood-brain barrier disruption, causing vasogenic edema.5 Immunosuppressive agents are known to cause PRES and may have contributed to our case. Systolic blood pressure: mmHg Diastolic blood pressure: mmHg Mean arterial blood pressure: mmHg Sodium: mmol/L Heart rate: bpm Ferritin: ng/mL D-dimer: ng/mL Please note: