To study demographic variables, background, risk factors, type of presentation and outcome of Posterior Reversible Encephalopathy Syndrome (PRES) in transplant patients

The study included 23 patients, median age 39.2 years, 30% were female. Twenty patients underwent solid organ transplant (7 kidney, 5 heart, 4 liver, 4 others) and 3 stem cell transplants. Twelve patients had a history of renal failure and ten of arterial hypertension. Immunosuppressive therapy with steroids was common (18), followed by tacrolimus (14), mofetil mycophenolate and cyclosporine (8 each).

Systemic infection was associated to PRES development in 82.6% of patients and hemodynamic fluctuations in 52%. The most frequent clinical presentation was awareness fluctuation in 87%, seizure in 56.5% and visual symptoms in 52%.

There were 21 cases studied with MRI, all with vasogenic supratentorial oedema, 14.2% were infratentorial. Atypical signs were visualized in 95% of cases: cortical localization in 66.6%, cytotoxic oedema in 33.3%, and hemorrhagic lesions in 19%.

Lumbar punction was done in 14 cases, 64.2% with albumin-cytological dissociation.

PRES is an expression of complex clinical and metabolic disturbs, with a typical brain damage that frequently occurs in transplant patients. In our case series clinical presentation was similar to that reported in the literature, however with a different image presentation and development