每日一题_2023.06.01

A 35-year-old man with IgA nephropathy presented with confusion, blurry vision, and seizures. Two weeks before presentation, he had started receiving cyclosporine. Physical examination was notable for a blood pressure of 160/80 mm Hg, drowsiness, and decreased visual acuity. A fundoscopic examinations was normal. T2-weighted magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery sequencing of the head was performed. What is the most likely diagnosis?

一名35岁男性IgA肾病患者表现为意识错乱、视物模糊和癫痫发作。就诊前2周，患者已开始接受环孢素治疗。体格检查发现血压为160/80 mmhg、嗜睡和视力下降。眼底镜检查正常。我们对头部进行了液体衰减反转恢复序列的t2加权磁共振成像(MRI)。最有可能的诊断是什么?

A. Acute demyelinating encephalomyelitis 急性脱髓鞘性脑脊髓炎

B. Methanol ingestion 甲醇摄入

C. Multifocal ischemic infarcts 多灶性缺血性梗死

D. Posterior reversible encephalopathy syndrome 可逆性后部脑病综合征

E. West Nile virus encephalitis 西尼罗病毒脑炎

答案解析：

诊断为环孢素所致可逆性后部脑病综合征(PRES)。停用环孢素1周后，患者症状及MRI表现缓解。

正确答案：D