Reversible posterior leukoencephalopathy syndrome after blood transfusion in a patient with end-stage renal disease

Clin Exp Nephrol. 2011 Dec;15(6):942-7. doi: 10.1007/s10157-011-0515-0. Epub 2011 Sep 7.


A 42-year-old female end-stage renal disease (ESRD) patient with reversible posterior leukoencephalopathy syndrome (RPLS) post-transfusion during initiation of hemodialysis is reported. Eleven days after the onset of illness, we diagnosed encephalopathy as a grand mal seizure resulting from diffuse cerebral edema. One reason for the delayed diagnosis was that her symptom, a throbbing headache that occurred during her first dialysis, indicated dialysis disequilibrium syndrome. We must bear in mind that a small amount of transfusion could cause RPLS even during the first dialysis. To our knowledge, this is the first case report on RPLS after blood transfusion in an ESRD patient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anemia / etiology
  • Anemia / therapy*
  • Brain Edema / etiology
  • Cerebral Angiography / methods
  • Delayed Diagnosis
  • Diffusion Magnetic Resonance Imaging
  • Epilepsy, Tonic-Clonic / etiology
  • Female
  • Glucocorticoids / therapeutic use
  • Glycerol / therapeutic use
  • Headache / etiology
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Methylprednisolone / therapeutic use
  • Posterior Leukoencephalopathy Syndrome / diagnosis
  • Posterior Leukoencephalopathy Syndrome / drug therapy
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Renal Dialysis / adverse effects*
  • Time Factors
  • Tomography, X-Ray Computed
  • Transfusion Reaction*
  • Treatment Outcome


  • Glucocorticoids
  • Glycerol
  • Methylprednisolone