Albuminocytologic Dissociation in Posterior Reversible Encephalopathy Syndrome

Mayo Clinic Proceedings
Sudhir DatarSara Hocker

Abstract

To describe cerebrospinal fluid (CSF) findings in patients with posterior reversible encephalopathy syndrome (PRES) and to study its association with vasogenic edema. Retrospective review of 73 consecutive prospectively collected adults diagnosed with PRES from January 1, 2000, through December 31, 2014, who underwent lumbar puncture. Seventy-three patients (mean age, 51±17 years), were included in the analysis; of these, 50 (69%) were women. The most common causes for PRES were hypertension (n=61 [84%]) and immunosuppression (n=22 [30%]). Renal failure was present in 42 (58%) patients. The median interval between clinical onset of PRES and CSF analysis was 1 day (interquartile range [IQR], 0-2 days). The median opening pressure was 23 cm H2O or 17 mm Hg (IQR, 18-28 cm H2O or 13-21 mm Hg), although it was available in only 27 patients. The median CSF protein level was 58 mg/dL (IQR, 44-81 mg/dL; normal value, <35 mg/dL). The median CSF protein level was higher in patients with more extensive vasogenic edema. The median white blood cell count was 1 cell/μL (IQR, 1-2 cells/μL). Elevated CSF protein level without CSF pleocytosis commonly occurs in patients with PRES and is directly associated with the extent and topographical dist...Continue Reading

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Citations

Apr 5, 2018·The New England Journal of Medicine·Steven M BlumJoseph Loscalzo
Mar 9, 2018·Case Reports in Neurology·Sang-Woo Lee, Seung-Jae Lee
Dec 12, 2018·Current Opinion in Neurology·Thomas G LimanMatthias Endres
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Jan 6, 2017·Journal of Neurology·Marlene Fischer, Erich Schmutzhard
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Feb 26, 2021·Case Reports in Neurological Medicine·Joseph Seemiller, Muhammad Taimur Malik
Apr 13, 2021·Journal of Clinical Immunology·Christopher NelkeTobias Ruck
Jul 20, 2021·Internal Medicine·Yuya AndoSachiko Ono

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