Post-transfusion reversible posterior leukoencephalopathy syndrome with cerebral vasoconstriction

Abstract

Reversible posterior leukoencephalopathy syndrome (RPLS) is a newly characterized clinico-neuroradiologic syndrome.1 Symptoms of this syndrome include seizures, visual abnormalities, cortical blindness, headache, nausea, lethargy, confusion, and hypertension. Radiologically, abnormalities consistent with reversible white matter edema in the occipital and parietal lobes are characteristic. Underlying conditions that reportedly trigger RPLS include hypertensive encephalopathy, eclampsia, and immunosuppressive drug therapy for neoplasm or organ transplantation. We report a case of RPLS that occurred after blood transfusion. Case report. A 45-year-old woman with no significant history was referred to a local gynecologist for shortness of breath and bilateral pedal edema. She had myoma uteri, abnormal vaginal bleeding, and iron deficiency anemia. Her hemoglobin was 2.0 g/dl and her hematocrit was 9.0%. Packed red blood cell infusion of 200 ml was performed four times, in addition to daily intravenous administration of saccharated ferric oxide. Her hemoglobin subsequently increased to 10.0 g/dl and her hematocrit improved to …