Ciclosporin-related posterior reversible encephalopathy syndrome in a paediatric haematopoietic stem cell transplant recipient

Posterior reversible encephalopathy syndrome (PRES) is a neurological condition associated with seizures, visual disturbances and altered mental status. It is commonly linked to immunosuppressive therapies such as ciclosporin, widely used in recipients of a haematopoietic stem cell transplant (HSCT). Neuroimaging, especially MRI, is the most important diagnostic tool for PRES, as it typically shows bilateral and symmetrical involvement of the occipital and parietal regions with white matter oedema.Electroencephalography may be useful for the detection of (non-convulsive) epileptic seizures, status epilepticus and may play a role in the evaluation of encephalopathy. We present the case of a 12-year-old boy who developed PRES during ciclosporin treatment for graft versus host disease prophylaxis following allogeneic HSCT. After early recognition, discontinuation of ciclosporin and appropriate management, full clinical recovery was achieved. This case highlights the importance of early detection and multidisciplinary management to prevent permanent neurological damage in paediatric recipients of a transplant.