Posterior reversible encephalopathy syndrome induced after blood transfusion for severe anemia


Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, confusion, seizures, and cortical visual loss, as well as subcortical edema without infarction on neuroimaging. We report a 56-year-old woman who developed typical manifestations of PRES, 6 days after blood transfusion for severe anemia. Acute volume overloads by transfusion may exceed the capacity of autoregulation of perfusion pressure, possibly resulting in vasogenic edema. We propose that it is clinically important to recognize that rapid correction of anemia by blood transfusion may carry the risk of inducing PRES.

Share and Cite:

Wada, K. , Kano, M. , Machida, Y. , Hattori, N. and Miwa, H. (2013) Posterior reversible encephalopathy syndrome induced after blood transfusion for severe anemia. Case Reports in Clinical Medicine, 2, 332-334. doi: 10.4236/crcm.2013.25089.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Hinchey, J., et al. (1996) A reversible posterior leukoencephalopathy syndrome. The New England Journal of Medicine, 2, 494-500. doi:10.1056/NEJM199602223340803
[2] Legriel, S., Pico, F. and Azoulay, E. (2011) Understanding posterior reversible encephalopathy syndrome. In: Vincent, J.L., Ed., Annual Update in Intensive Care and Emergency Medicine, Springer, Berlin, 631-653.
[3] Feske, S.K. (2011) Posterior reversible encephalopathy syndrome: A review. Seminars in Neurology, 31, 202-215. doi:10.1055/s-0031-1277990
[4] Ito, Y., et al. (1997) Post-transfusion reversible posterior leukoencephalopathy syndrome with cerebral vasoconstriction. Neurology, 49, 1174-1175. doi:10.1212/WNL.49.4.1174
[5] Boughammoura, A., Touzé, E., Oppenheim, C., Trystram, D. and Mas, J.L. (2003) Reversible angiopathy and encephalopathy after blood transfusion. Journal of Neurology, 250, 116-118. doi:10.1007/s00415-003-0940-4
[6] Heo, K., Park, S., Lee, J.Y., Lee, B.I. and Lee, S.K. (2003) Post-transfusion posterior leukoencephalopathy with cytotoxic and vasogenic edema precipitated by vasospasm. Cerebrovascular Diseases, 15, 230-233. doi:10.1159/000068825
[7] Kawano, H., Suga, T., Terasaki, T., Hashimoto, Y., Baba, K. and Uchino, M. (2004) Posterior encephalopathy syndrome in two patients after cancer surgery with transfusion. Rinsho Shinkeigaku, 44, 427-431.
[8] Huang, Y.C., Tsai, P.L., Yeh, J.H. and Chen, W.H. (2008) Reversible posterior leukoencephalopathy syndrome caused by blood transfusion: A case report. Acta Neurologica Taiwanica, 17, 258-262.
[9] Sato, T., et al. (2011) Reversible posterior leukoencephalopathy syndrome after blood transfusion in a patient with end-stage renal disease. Clinical and Experimental Nephrology, 15, 942-947. doi:10.1007/s10157-011-0515-0
[10] Li, Y., Gor, D., Walicki, D., Jenny, D., Jones, D., Barbour, P. and Castaldo, J. (2012) Spectrum and potential pathogenesis of reversible posterior leukoencephalopathy syndrome. Journal of Stroke and Cerebrovascular Diseases, 21, 873-882. doi:10.1016/j.jstrokecerebrovasdis.2011.05.010

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.