Blood transfusion induced posterior reversible encephalopathy syndrome in a case of abnormal uterine bleeding-polyps with chronic very severe anaemia

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rarely reported medical event across globe. Although PRES is primarily associated with pre-eclampsia, hypertension, auto-immune disorders and cytotoxic drug treatments, a rare fraction has been recently discovered due to transfusion of blood in rapid succession to the patients with chronic severe anemia. Postulated causation which is accepted overall; is due to hypoperfusion and vasogenic edema despite normal blood pressure. Pathology behind this disorder are endothelial dysfunction and breach of blood brain barrier. Cerebral lobes that are primarily affected are parietal and posterior occipital cortex which leads to headache, altered mental status, seizures, and visual disturbances. Its diagnosis is established only after proper clinicoradiological evaluation with aid of MRI. It is prudent to keep in mind about this rare clinical entity while assessing a patient in ward with visual disturbances, headache, and tonic-clonic seizures with normal blood pressure in the setting of chronic severe anemia and there is a history of multiple blood transfusions recently. Its prognosis is satisfactory with no report of fatality.