RESUMEN
Human recombinant erythropoietin is used to treat chronic anemia in patients with end-stage renal failure. Erythropoietin causes hypertension, and hypertensive encephalopathy has been associated with its use. We describe six dialysis-dependent, chronic renal failure patients who developed hypertension, headache, and seizures while on erythropoietin. Four of the six patients had posterior white matter changes on neuroimaging. The encephalopathy was managed by prompt antihypertensive and anticonvulsant treatment and by discontinuation of erythropoietin. Hypertensive posterior leukoencephalopathy is associated with erythropoietin use.
Asunto(s)
Encefalopatías/inducido químicamente , Eritropoyetina/efectos adversos , Hipertensión/inducido químicamente , Fallo Renal Crónico/tratamiento farmacológico , Adulto , Anemia/tratamiento farmacológico , Anemia/etiología , Anticonvulsivantes/uso terapéutico , Encefalopatías/diagnóstico , Encefalopatías/etiología , Encefalopatías/prevención & control , Niño , Esquema de Medicación , Eritropoyetina/administración & dosificación , Eritropoyetina/uso terapéutico , Humanos , Hipertensión/complicaciones , Hipertensión/prevención & control , Fallo Renal Crónico/complicaciones , Imagen por Resonancia Magnética , Persona de Mediana Edad , Proteínas RecombinantesRESUMEN
Isolated angiitis of the central nervous system (IAC) was diagnosed in a 40-year-old Caucasian male by histological examination of a leptomeningeal biopsy specimen, and the exclusion of systemic inflammatory or infective disease. Therapy with prednisone 30 mg/day and cyclophosphamide 100 mg/day resulted in clinical and radiological improvement, which have been maintained for an 8-month follow-up period. Magnetic resonance imaging (MRI) showed lesions implicating involvement of specific penetrating vessels at the base of the brain, an unusual complication of IAC, and allowed an accurate MRI-clinical correlation.