Oral cyclosporine, hypertension and hypomagnesemia are possible risk factors for posterior leukoencephalopathy syndrome in a boy with aplastic anemia

Abstract

This is a case of posterior leukoencephalopathy syndrome (PLES) in an 11-year-old African-American male treated with oral cyclosporine while on admission for idiopathic aplastic anemia in the intensive care unit at Louisiana State University, Shreveport, USA. The patient had tonic-clonic seizures preceded by visual hallucinations and hypertension. Magnetic resonance imaging with fluid attenuated inversion-recovery sequences revealed presence of cerebral edema in the cortical and subcortical regions of the frontal, supraventricular and posterior parietal lobes consistent with PLES. Resolution of PLES lesions occurred with a 25% reduction in dose of oral cyclosporine, control of seizure activity and treatment of hypertension. Patient recovered completely and was discharged home on anticonvulsant and antihypertensive medications that were subsequently discontinued at follow-up visit.

Keywords

PLES - cyclosporine - hypertension - hypomagnesemia - seizures - aplastic anemia