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Case Reports in Medicine
Volume 2012, Article ID 914035, 3 pages
http://dx.doi.org/10.1155/2012/914035
Case Report

Recurrent Posterior Reversible Encephalopathy Syndrome Potentially Related to AIDS and End-Stage Renal Disease: A Case Report and Review of the Literature

1Department of Internal Medicine, Tulane University School of Medicine, SL-12, 1430 Tulane Avenue, New Orleans, LA 70112-2699, USA
2Department of Obstetrics and Gynecology, Tulane University School of Medicine, SL-12, 1430 Tulane Avenue, New Orleans, LA 70112-2699, USA

Received 20 June 2012; Revised 21 August 2012; Accepted 9 September 2012

Academic Editor: Bruno Megarbane

Copyright © 2012 Olivia Hui-Chiun Chang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome that is characterized by clinical features including headache, altered mental status, cortical blindness, seizures, and other focal neurological signs as well as subcortical edema without infarction on neuroimaging. Under the umbrella of hypertensive encephalopathy, PRES is defined by reversible cerebral edema due to dysfunction of the cerebrovascular blood-brain barrier unit. The pathophysiology of PRES is thought to result from abnormalities in the transmembrane flow of intravascular fluid and proteins caused by two phenomena: one, cerebral autoregulatory failure and two, loss of integrity of the blood-brain barrier. PRES is not a common disease in patients with human immunodeficiency virus (HIV) and AIDS with only three previously reported cases. Both the HIV and end-stage renal disease appear to further compromise the blood brain barrier. Although uncommon, PRES recurrence has been described. To the best of our knowledge, this is the first report demonstrating recurrent PRES in a HIV patient on hemodialysis for end-stage renal disease.