原发性甲状旁腺功能亢进导致可逆性后部白质脑病综合征1例

One case of primary hyperparathyroidism induced posterior reversible encephalopathy syndrome

可逆性后部脑病综合征(posterior reversible encephalopathy syndrome, PRES)是一种多病因的神经临床影像综合征。临床表现为头痛、迅速进展的颅高压症状、癫痫发作、视觉障碍、精神异常,经典影像学改变为可逆性大脑后部顶枕叶白质损害。PRES常见的诱发原因包括高血压、肾功能衰竭、先兆子痫/子痫、器官移植后和使用细胞毒性药物。原发性甲状旁腺功能亢进症(primary hyperparathyroidism, PHPT)引起高钙血症是PRES的一个罕见原因。本院近期收治了1例经临床、影像及病理检查确诊的PHPT引起高钙血症,导致PRES的青年女性患者,结合病例特点及复习相关文献进行报道。

Posterior reversible encephalopathy syndrome(PRES)is a multicausal neuroclinical imaging syndrome.The clinical manifestations are headache,rapidly progressive intracranial hypertension symptoms,seizures,visual disturbances,psychiatric abnormalities,and classic imaging changes was reversible parieto-occipital white matter damage in the posterior part of the brain.Common predisposing causes of PRES include hypertension,renal failure,preeclampsia/eclampsia,organ transplantation postoperative,and use of cytotoxic drugs.Hypercalcemia due to primary hyperparathyroidism(PHPT)is a rare cause of PRES.We recently admitted a young female patient with PHPT causing hypercalcemia and leading to PRES,and the patient was confirmed by clinical,imaging and pathological examinations.Combined with the characteristics of the cases and review of relevant literature,the following reports are reported.