Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine

A 32-year-old lady developed status epilepticus and acute visual loss while on mesalamine for Crohn's disease. Her clinical course and magnetic resonance imaging (MRI) were suggestive of posterior reversible encephalopathy syndrome (PRES). She had periodic lateralized epileptiform discharges pl...

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Main Authors:	Cherian, Ajith, Soumya, C. V., Iype, Thomas, Mathew, Mini, Sandeep, P., Thadam, Jessline K., Chithra, P.
Format:	Online
Language:	English
Published:	Medknow Publications & Media Pvt Ltd 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985367/

id	pubmed-3985367
recordtype	oai_dc
spelling	pubmed-39853672014-04-16 Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine Cherian, Ajith Soumya, C. V. Iype, Thomas Mathew, Mini Sandeep, P. Thadam, Jessline K. Chithra, P. Case Report A 32-year-old lady developed status epilepticus and acute visual loss while on mesalamine for Crohn's disease. Her clinical course and magnetic resonance imaging (MRI) were suggestive of posterior reversible encephalopathy syndrome (PRES). She had periodic lateralized epileptiform discharges plus (PLEDs-plus) on electroencephalogram (EEG), which responded to sodium valproate. Her vision improved from counting fingers at one-meter distance to 6/12. Though different cytotoxic drugs have been implicated as causative agents, this is the first case report of mesalamine-induced PRES. This case highlights the need for aggressive treatment of PLEDs-plus with EEG monitoring using a broad-spectrum antiepileptic drug like valproate, which has contributed to the rapid reversibility of vision in PRES subjects, and the need for a thorough drug history for etiological clues. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC3985367/ /pubmed/24741259 http://dx.doi.org/10.4103/0976-3147.127882 Text en Copyright: © Journal of Neurosciences in Rural Practice http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Cherian, Ajith Soumya, C. V. Iype, Thomas Mathew, Mini Sandeep, P. Thadam, Jessline K. Chithra, P.
spellingShingle	Cherian, Ajith Soumya, C. V. Iype, Thomas Mathew, Mini Sandeep, P. Thadam, Jessline K. Chithra, P. Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
author_facet	Cherian, Ajith Soumya, C. V. Iype, Thomas Mathew, Mini Sandeep, P. Thadam, Jessline K. Chithra, P.
author_sort	Cherian, Ajith
title	Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
title_short	Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
title_full	Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
title_fullStr	Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
title_full_unstemmed	Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine
title_sort	posterior reversible encephalopathy syndrome with pleds-plus due to mesalamine
description	A 32-year-old lady developed status epilepticus and acute visual loss while on mesalamine for Crohn's disease. Her clinical course and magnetic resonance imaging (MRI) were suggestive of posterior reversible encephalopathy syndrome (PRES). She had periodic lateralized epileptiform discharges plus (PLEDs-plus) on electroencephalogram (EEG), which responded to sodium valproate. Her vision improved from counting fingers at one-meter distance to 6/12. Though different cytotoxic drugs have been implicated as causative agents, this is the first case report of mesalamine-induced PRES. This case highlights the need for aggressive treatment of PLEDs-plus with EEG monitoring using a broad-spectrum antiepileptic drug like valproate, which has contributed to the rapid reversibility of vision in PRES subjects, and the need for a thorough drug history for etiological clues.
publisher	Medknow Publications & Media Pvt Ltd
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985367/
_version_	1612077617052123136

Posterior reversible encephalopathy syndrome with PLEDs-plus due to mesalamine

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