Evidence mapPaperPMID 37773103Full record

ArticleBMC nephrology2023

Posterior reversible encephalopathy syndrome (PRES) associated with SARS-CoV-2 infection in a patient under maintenance haemodialysis: a case report.

Yuki Shimamoto, Hirohito Sasaki, Kenji Kasuno, Yuki Watanabe, Sayumi Sakashita, Sho Nishikawa, Kazuhisa Nishimori, Sayu Morita, Yudai Nishikawa, Mamiko Kobayashi and 7 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 2 institutions in 1 country.

Yuki ShimamotoDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Hirohito SasakiDivision of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Kenji KasunoDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan. kasuno@u-fukui.ac.jp.
Yuki WatanabeDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Sayumi SakashitaDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Sho NishikawaDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Kazuhisa NishimoriDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Sayu MoritaDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Yudai NishikawaDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Mamiko KobayashiDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Sachiko FukushimaDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Soichi EnomotoDivision of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Naoki TakahashiDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
Tadanori HamanoDivision of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Ippei SakamakiDepartment of Infectious Diseases, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Hiromichi IwasakiDivision of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan.
Masayuki IwanoDepartment of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki Eiheiji-cho Yoshida-gun, Fukui, Japan.
University of Fukui · JPUniversity of Fukui Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndothelial dysfunction is common in patients undergoing chronic haemodialysis, and is a major cause of posterior reversible encephalopathy syndrome (PRES). Recently, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to cause endothelial dysfunction by infecting vascular endothelial cells. Several cases of neurological complications in patients without kidney dysfunction, and only a few cases in patients with chronic kidney disease, have been reported in the literature. However, no previous report has yet described PRES associated with SARS-CoV-2 infection among patients undergoing maintenance dialysis. CASE PRESENTATION: A 54-year-old woman undergoing maintenance haemodialysis was admitted to our hospital for status epilepticus. She had developed end-stage kidney disease (ESKD) secondary to diabetic nephropathy. Seven days prior to admission, she had developed fever and was diagnosed with COVID-19. Subsequently her blood pressure increased from 160/90 mmHg to 190/100 mmHg. On admission, she presented with severe hypertension (> 220/150 mmHg), unconsciousness, and epilepticus. CT tomography revealed no signs of brain haemorrhage. Cranio-spinal fluid (CSF) examination revealed no signs of encephalitis, and CSF polymerase chain reaction (PCR) for SARS-CoV-2 was negative. MRI findings revealed focal T2/FLAIR hyperintensity in the bilateral parietooccipital regions, leading to the diagnosis of PRES. Deep sedation and strict blood pressure control resulted in a rapid improvement of her symptoms, and she was discharged without sequelae.

conclusionsWe report the first case of PRES associated with SARS-CoV-2 infection in a patient undergoing maintenance haemodialysis. Patients undergoing maintenance haemodialysis are at high risk of PRES because of several risk factors. SARS-CoV-2 infection causes direct invasion of endothelial cells by binding to angiotensin-converting enzyme 2 (ACE2), initiating cytokine release, and hypercoagulation, leading to vascular endothelial cell injury and increased vascular leakage. In the present case, SARS-CoV-2 infection possibly be associated with the development of PRES.

Indexed as

COVID-19Posterior Leukoencephalopathy SyndromeVascular DiseasesEndothelial CellsFemaleHumansMiddle AgedRenal DialysisSARS-CoV-2End-stage kidney diseaseHaemodialysisIntravascular endothelial cell injuryPosterior reversible encephalopathy syndromeStatus epilepticus

Identifiers

PMID37773103
PMCPMC10542676
OpenAlexW4387157408

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.