hypercalcemia

Encefalopatía Posterior Reversible asociada a hipercalcemia maligna: una presentación poco usual. Posterior Reversible Encephalopathy associated with malignant hypercalcemia: an unusual presentation

Posterior reversible encephalopathy syndrome (PRES) is a transient clinical condition associated with a loss of cerebral vascular regulation. We present the case of a patient diagnosed with abdominal diffuse large B-cell lymphoma who presented to the emergency department with visual impairment, headache, and seizures. A brain magnetic resonance imaging showed T2 bilateral occipital hyperintensity and on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) showed hyperintense signal, consistent with vasogenic edema compatible with PRES, with no additional findings on images or in cerebrospinal fluid. The only abnormal metabolic finding was hypercalcemia. Metastatic involvement of the central nervous system was ruled out. Medical management of the hypercalcemia was performed, achieving complete resolution of the patient’s symptoms with reversibility of the imaging alterations 6 weeks after the episode.