Paroxysmal Nocturnal Hemoglobinuria with Posterior Reversible Encephalopathy Syndrome: A Case Report

doi:10.3969/j.issn.1673-5765.2024.06.010

Chinese Journal of Stroke ›› 2024, Vol. 19 ›› Issue (6): 699-705.DOI: 10.3969/j.issn.1673-5765.2024.06.010

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Paroxysmal Nocturnal Hemoglobinuria with Posterior Reversible Encephalopathy Syndrome: A Case Report

ZHAO Xin¹, XUE Wei^1,2, ZHU Xinli³, JING Dongqing^1,4, HONG Fan¹, GUO Xiao¹, LIU Junling¹

1 Department of Neurology, Affiliated Hospital of Shandong Second Medical University, Weifang 261031, China
2 Department of Neurology, Yidu Central Hospital of Weifang, Weifang 262500, China
3 Electrophysiological Center, Affiliated Hospital of Shandong Second Medical University, Weifang 261031, China
4 Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang 261031, China

Received:2023-12-21 Online:2024-06-20 Published:2024-06-20
Contact: LIU Junling, E-mail: junlingliu@wfmc.edu.cn

阵发性睡眠性血红蛋白尿症伴可逆性后部脑病综合征1例报道

赵鑫¹，薛伟^1，2，祝新莉³，井冬青^1，4，洪帆¹，郭筱¹，刘君玲¹

1 潍坊261031 山东第二医科大学附属医院神经内科
2 潍坊市益都中心医院神经内科
3 山东第二医科大学附属医院电生理中心
4 山东第二医科大学附属医院临床研究中心

通讯作者: 刘君玲 junlingliu@wfmc.edu.cn
基金资助:
山东省自然科学基金面上项目（ZR2020MH159）
教育部产学合作协同育人项目（230803175095715）
潍坊医学院优质专业学位教学案例库（22YZSALK11）
潍坊医学院研究生科研创新基金项目（2022YJSCX021）

Abstract

Abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinical-imaging syndrome dominated by reversible neurological damage and specific imaging manifestations, and paroxysmal nocturnal hemoglobinuria (PNH) is a clinically rare disease. This paper described a case of an elderly male patient with PNH who had long-term chronic hemolytic anemia. After irregularly taking low-dose immunosuppressants and short-term intermittent infusion of 10 U of washed erythrocytes, he developed a PRES with headache, seizures, mental behavioural abnormalities, abnormally high blood pressure, and trace subarachnoid hemorrhage. It should be differentiated from diseases such as cerebral venous and venous sinus thrombosis and reversible cerebral vasoconstriction syndrome. The aim of this paper is to improve the clinicians’ ability to prevent and identify this type of patients at an early stage.

Key words: Paroxysmal nocturnal hemoglobinuria; Posterior reversible encephalopathy syndrome; Blood transfusion; Subarachnoid hemorrhage; Seizure

摘要： 可逆性后部脑病综合征（posterior reversible encephalopathy syndrome，PRES）是一种以可逆性神经系统损害和特异性影像学表现为主的临床-影像学综合征，阵发性睡眠性血红蛋白尿症（paroxysmal nocturnal hemoglobinuria，PNH）是临床上的罕见疾病。本文介绍1例有PNH的老年男性患者，患者长期慢性溶血性贫血，不规律服用小剂量免疫抑制剂，短期间断输入共计10 U洗涤红细胞后，出现伴有头痛、痫性发作、精神行为异常、血压异常增高及微量蛛网膜下腔出血的PRES，此病需与脑静脉及静脉窦血栓形成和可逆性脑血管收缩综合征等疾病相鉴别。本文旨在提高临床医师对此类患者的预防、早期识别及应对能力。

关键词: 阵发性睡眠性血红蛋白尿症; 可逆性后部脑病综合征; 输血; 蛛网膜下腔出血; 痫性发作

CLC Number:

ZHAO Xin, XUE Wei, ZHU Xinli, JING Dongqing, HONG Fan, GUO Xiao, LIU Junling. Paroxysmal Nocturnal Hemoglobinuria with Posterior Reversible Encephalopathy Syndrome: A Case Report[J]. Chinese Journal of Stroke, 2024, 19(6): 699-705.

赵鑫, 薛伟, 祝新莉, 井冬青, 洪帆, 郭筱, 刘君玲. 阵发性睡眠性血红蛋白尿症伴可逆性后部脑病综合征1例报道[J]. 中国卒中杂志, 2024, 19(6): 699-705.

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Paroxysmal Nocturnal Hemoglobinuria with Posterior Reversible Encephalopathy Syndrome: A Case Report

阵发性睡眠性血红蛋白尿症伴可逆性后部脑病综合征1例报道

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