Albuminocytologic Dissociation in Posterior Reversible Encephalopathy Syndrome.

Abstract:

OBJECTIVES:To describe cerebrospinal fluid (CSF) findings in patients with posterior reversible encephalopathy syndrome (PRES) and to study its association with vasogenic edema. PATIENTS AND METHODS:Retrospective review of 73 consecutive prospectively collected adults diagnosed with PRES from January 1, 2000, through December 31, 2014, who underwent lumbar puncture. RESULTS: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). CONCLUSION:Elevated CSF protein level without CSF pleocytosis commonly occurs in patients with PRES and is directly associated with the extent and topographical distribution of cerebral edema. Although mild CSF pleocytosis can also occur, it is an uncommon finding and may prompt consideration for further diagnostic testing.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Datar S,Singh TD,Fugate JE,Mandrekar J,Rabinstein AA,Hocker S

doi

10.1016/j.mayocp.2015.07.018

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1366-71

issue

10

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(15)00600-X

journal_volume

90

pub_type

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